#2009 of 11K

E0245

HCPCS Procedure Code

HCPCS code E0245 is the #2,009 most-billed Medicaid procedure code, with $10.1M in payments across 237K claims from 2018–2024. The national median cost per claim is $42.10.

Total Paid

$10.1M

0.00% of all spending

Total Claims

237K

Providers

303

Avg Cost/Claim

$43

National Cost Distribution

How much do providers bill per claim for E0245? Based on 302 providers billing this code nationally.

Median

$42.10

Average

$45.57

Std Dev

$27.24

Max

$328.76

Percentile Distribution (Cost per Claim)

p10

$20.75

p25

$30.64

Median

$42.10

p75

$55.67

p90

$66.77

p95

$83.36

p99

$119.72

50% of providers bill between $30.64 and $55.67 per claim for this code.

90% bill between $20.75 and $66.77.

Top 1% bill above $119.72.

About This Procedure

HCPCS code E0245 was billed by 303 providers across 237K claims, totaling $10.1M in Medicaid payments from 2018–2024. This code was used for 225K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.10

Providers Billing

302

National Spending

$10.1M

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0245

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1861576282	$957K	$119.73	2.8× median	Top 1%
2	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$671K	$28.22	0.7× median	Below Median
3	1730182023	$496K	$52.48	1.2× median	Above Median
4	1922046085	$354K	$54.74	1.3× median	Above Median
5	1144207911	$244K	$82.39	2.0× median	Top 10%
6	Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies	$226K	$42.68	1.0× median	Above Median
7	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$225K	$44.24	1.1× median	Above Median
8	1427153626	$217K	$37.44	0.9× median	Below Median
9	1023017647	$192K	$58.32	1.4× median	Above 75th
10	1346248341	$185K	$31.22	0.7× median	Below Median
11	1265526396	$178K	$32.76	0.8× median	Below Median
12	1386688414	$168K	$50.08	1.2× median	Above Median
13	1558458489	$165K	$54.23	1.3× median	Above Median
14	1689665911	$146K	$97.60	2.3× median	Top 10%
15	1629072665	$146K	$35.29	0.8× median	Below Median
16	1851328157	$144K	$42.21	1.0× median	Above Median
17	1588603492	$137K	$64.01	1.5× median	Above 75th
18	1538201264	$137K	$39.90	0.9× median	Below Median
19	1063710986	$129K	$62.17	1.5× median	Above 75th
20	1750488680	$118K	$60.33	1.4× median	Above 75th

Showing top 20 of 303 providers billing this code

Related Procedures

E0240$42.1M E0247$9.3M E0241$7.0M E0244$3.0M E0250$1.6M

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