#2716 of 11K

E0185

HCPCS Procedure Code

HCPCS code E0185 is the #2,716 most-billed Medicaid procedure code, with $4.0M in payments across 100K claims from 2018–2024. The national median cost per claim is $38.42. Costs vary widely — the 90th percentile is $79.90 per claim, 2.1× the median.

Total Paid

$4.0M

0.00% of all spending

Total Claims

100K

Providers

130

Avg Cost/Claim

$40

National Cost Distribution

How much do providers bill per claim for E0185? Based on 127 providers billing this code nationally.

Median

$38.42

Average

$45.84

Std Dev

$36.23

Max

$263.01

Percentile Distribution (Cost per Claim)

p10

$12.76

p25

$24.38

Median

$38.42

p75

$57.43

p90

$79.90

p95

$99.12

p99

$164.56

50% of providers bill between $24.38 and $57.43 per claim for this code.

90% bill between $12.76 and $79.90.

Top 1% bill above $164.56.

About This Procedure

HCPCS code E0185 was billed by 130 providers across 100K claims, totaling $4.0M in Medicaid payments from 2018–2024. This code was used for 91K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$38.42

Providers Billing

127

National Spending

$4.0M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0185

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$759K	$32.63	0.8× median	Below Median
2	Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier	$662K	$51.92	1.4× median	Above Median
3	1053314021	$218K	$78.79	2.1× median	Above 75th
4	1134303902	$177K	$53.72	1.4× median	Above Median
5	1730182023	$143K	$24.67	0.6× median	Below Median
6	1750331484	$131K	$78.43	2.0× median	Above 75th
7	1326077249	$130K	$51.32	1.3× median	Above Median
8	1881623627	$111K	$164.73	4.3× median	Top 1%
9	1093716334	$104K	$41.16	1.1× median	Above Median
10	1659361947	$92K	$73.98	1.9× median	Above 75th
11	1477684132	$82K	$36.70	1.0× median	Below Median
12	1154434819	$75K	$48.86	1.3× median	Above Median
13	1114267127	$74K	$40.94	1.1× median	Above Median
14	1497783088	$71K	$47.70	1.2× median	Above Median
15	1285783712	$68K	$63.76	1.7× median	Above 75th
16	1003154352	$63K	$59.66	1.6× median	Above 75th
17	1134120074	$61K	$65.79	1.7× median	Above 75th
18	1275523581	$56K	$53.55	1.4× median	Above Median
19	1760686117	$49K	$39.59	1.0× median	Above Median
20	1255632394	$46K	$29.06	0.8× median	Below Median

Showing top 20 of 130 providers billing this code

Related Procedures

E0194$25.7M E0190$2.5M E0181$1.4M E0193$1.0M E0184$439K

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