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#1086 of 11K

E0240

HCPCS Procedure Code

HCPCS code E0240 is the #1,086 most-billed Medicaid procedure code, with $42.1M in payments across 379K claims from 2018–2024. The national median cost per claim is $62.75. Costs vary widely — the 90th percentile is $1,230.25 per claim, 19.6× the median.

Total Paid

$42.1M

0.00% of all spending

Total Claims

379K

Providers

388

Avg Cost/Claim

$111

National Cost Distribution

How much do providers bill per claim for E0240? Based on 384 providers billing this code nationally.

Median

$62.75

Average

$280.28

Std Dev

$514.53

Max

$2,579.69

Percentile Distribution (Cost per Claim)

p10
$26.49
p25
$34.33
Median
$62.75
p75
$155.34
p90
$1,230.25
p95
$1,539.62
p99
$2,292.50

50% of providers bill between $34.33 and $155.34 per claim for this code.

90% bill between $26.49 and $1,230.25.

Top 1% bill above $2,292.50.

About This Procedure

HCPCS code E0240 was billed by 388 providers across 379K claims, totaling $42.1M in Medicaid payments from 2018–2024. This code was used for 361K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$62.75

Providers Billing

384

National Spending

$42.1M

Avg/Median Ratio

4.47×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for E0240

#ProviderTotal Paid
11487624193$2.0M
21902815665$1.7M
31750332797$1.7M
4Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$1.6M
51922006741$1.3M
61477526333$1.2M
71841263621$1.1M
81609858752$1.1M
91053384990$1.1M
101619971025$1.0M
111144515255$1.0M
121477594877$991K
131558428979$986K
14Tenderheart Health Outcomes, Inc.

Austin, TX · Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition

$962K
151710984869$906K
161669570172$896K
171235102179$884K
18Integra Partners Llc

Troy, MI · Orthotic Fitter

$788K
19Apria Healthcare Llc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$741K
201679546519$629K

Showing top 20 of 388 providers billing this code