#1708 of 11K

E0163

HCPCS Procedure Code

HCPCS code E0163 is the #1,708 most-billed Medicaid procedure code, with $15.8M in payments across 481K claims from 2018–2024. The national median cost per claim is $27.98. Costs vary widely — the 90th percentile is $56.88 per claim, 2.0× the median.

Total Paid

$15.8M

0.00% of all spending

Total Claims

481K

Providers

559

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for E0163? Based on 555 providers billing this code nationally.

Median

$27.98

Average

$31.45

Std Dev

$17.64

Max

$93.21

Percentile Distribution (Cost per Claim)

p10

$11.45

p25

$18.67

Median

$27.98

p75

$40.85

p90

$56.88

p95

$65.79

p99

$79.33

50% of providers bill between $18.67 and $40.85 per claim for this code.

90% bill between $11.45 and $56.88.

Top 1% bill above $79.33.

About This Procedure

HCPCS code E0163 was billed by 559 providers across 481K claims, totaling $15.8M in Medicaid payments from 2018–2024. This code was used for 437K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.98

Providers Billing

555

National Spending

$15.8M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0163

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$2.3M	$75.86	2.7× median	Top 10%
2	Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier	$1.3M	$30.73	1.1× median	Above Median
3	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$765K	$40.10	1.4× median	Above Median
4	Integra Partners Llc Troy, MI · Orthotic Fitter	$375K	$38.62	1.4× median	Above Median
5	Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies	$310K	$48.49	1.7× median	Above 75th
6	1255632394	$276K	$41.43	1.5× median	Above 75th
7	1730182023	$261K	$18.15	0.6× median	Below Median
8	1134303902	$212K	$24.67	0.9× median	Below Median
9	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$182K	$41.59	1.5× median	Above 75th
10	1922046085	$174K	$66.16	2.4× median	Top 10%
11	1669417531	$168K	$28.26	1.0× median	Above Median
12	1093716334	$162K	$27.35	1.0× median	Below Median
13	1144371204	$158K	$39.66	1.4× median	Above Median
14	Palmetto Oxygen Llc Cary, NC · Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies	$158K	$29.81	1.1× median	Above Median
15	1912092594	$157K	$37.43	1.3× median	Above Median
16	Medline Industries, Lp Grayslake, IL · Durable Medical Equipment & Medical Supplies	$153K	$37.73	1.3× median	Above Median
17	1174749972	$150K	$34.41	1.2× median	Above Median
18	1326077249	$145K	$51.34	1.8× median	Above 75th
19	1033142484	$144K	$52.00	1.9× median	Above 75th
20	1407894348	$136K	$37.84	1.4× median	Above Median

Showing top 20 of 559 providers billing this code

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