E0197
HCPCS Procedure Code
HCPCS code E0197 is the #5,406 most-billed Medicaid procedure code, with $207K in payments across 2K claims from 2018–2024. The national median cost per claim is $11.18. Costs vary widely — the 90th percentile is $131.73 per claim, 11.8× the median.
Total Paid
$207K
0.00% of all spending
Total Claims
2K
Providers
7
Avg Cost/Claim
$94
National Cost Distribution
How much do providers bill per claim for E0197? Based on 7 providers billing this code nationally.
Median
$11.18
Average
$42.33
Std Dev
$61.79
Max
$136.15
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.18 and $71.13 per claim for this code.
90% bill between $1.94 and $131.73.
Top 1% bill above $135.71.
About This Procedure
HCPCS code E0197 was billed by 7 providers across 2K claims, totaling $207K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$11.18
Providers Billing
7
National Spending
$207K
Avg/Median Ratio
3.79×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for E0197
| # | Provider | Total Paid |
|---|---|---|
| 1 | Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies | $192K |
| 2 | Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital | $11K |
| 3 | 1790094696 | $3K |
| 4 | 1922006741 | $512 |
| 5 | 1710325253 | $277 |
| 6 | 1518162155 | $146 |
| 7 | 1730182023 | $65 |
Showing top 7 of 7 providers billing this code