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#3570 of 11K

E0255

HCPCS Procedure Code

HCPCS code E0255 is the #3,570 most-billed Medicaid procedure code, with $1.5M in payments across 57K claims from 2018–2024. The national median cost per claim is $14.03. Costs vary widely — the 90th percentile is $58.70 per claim, 4.2× the median.

Total Paid

$1.5M

0.00% of all spending

Total Claims

57K

Providers

63

Avg Cost/Claim

$26

National Cost Distribution

How much do providers bill per claim for E0255? Based on 63 providers billing this code nationally.

Median

$14.03

Average

$23.44

Std Dev

$22.29

Max

$91.20

Percentile Distribution (Cost per Claim)

p10
$6.25
p25
$9.12
Median
$14.03
p75
$27.79
p90
$58.70
p95
$68.50
p99
$89.06

50% of providers bill between $9.12 and $27.79 per claim for this code.

90% bill between $6.25 and $58.70.

Top 1% bill above $89.06.

About This Procedure

HCPCS code E0255 was billed by 63 providers across 57K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 50K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.03

Providers Billing

63

National Spending

$1.5M

Avg/Median Ratio

1.67×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for E0255

#ProviderTotal Paid
11447277264$224K
21730221599$209K
31336123678$154K
41467415414$127K
51497837280$126K
61144280041$99K
71457348807$68K
81972554939$62K
91790758936$39K
101770738007$38K
111467014860$36K
121922006741$32K
131588994438$31K
141710259551$31K
151992759153$17K
161457314130$17K
171205837879$14K
181417991233$14K
191336269752$12K
201770118309$12K

Showing top 20 of 63 providers billing this code