Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#249 of 11K

E0465

Home ventilator, any type, used with invasive interface

Home ventilator, any type, used with invasive interface is the #249 most-billed Medicaid procedure code, with $582.0M in payments across 824K claims from 2018–2024. The national median cost per claim is $583.21.

Total Paid

$582.0M

0.05% of all spending

Total Claims

824K

Providers

327

Avg Cost/Claim

$706

National Cost Distribution

How much do providers bill per claim for E0465? Based on 324 providers billing this code nationally.

Median

$583.21

Average

$607.63

Std Dev

$278.84

Max

$2,001.77

Percentile Distribution (Cost per Claim)

p10
$306.76
p25
$419.53
Median
$583.21
p75
$736.12
p90
$902.04
p95
$1,100.59
p99
$1,646.66

50% of providers bill between $419.53 and $736.12 per claim for this code.

90% bill between $306.76 and $902.04.

Top 1% bill above $1,646.66.

About This Procedure

HCPCS code E0465 (Home ventilator, any type, used with invasive interface) was billed by 327 providers across 824K claims, totaling $582.0M in Medicaid payments from 2018–2024. This code was used for 612K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$583.21

Providers Billing

324

National Spending

$582.0M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0465

#ProviderTotal Paid
1Super Care Inc

City Of Industry, CA · Durable Medical Equipment & Medical Supplies

$41.3M
2The Promptcare Companies, Inc.

King Of Prussia, PA · Durable Medical Equipment & Medical Supplies

$30.4M
3Pediatric Home Respiratory Services Llc

Roseville, MN · Home Health

$30.2M
41083615991$19.6M
51871738153$15.9M
61902137409$15.0M
71922103142$12.9M
8Apple Homecare Medical Supply Llc

Richardson, TX · Durable Medical Equipment & Medical Supplies, Customized Equipment

$12.8M
91093873598$9.8M
101073680799$9.5M
111912923301$8.4M
121538128293$8.4M
13Integra Partners Llc

Troy, MI · Orthotic Fitter

$8.1M
141477748119$7.9M
15Apria Healthcare Llc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$7.7M
161710978390$6.9M
171861480048$6.8M
181992764658$6.5M
191558368589$6.3M
201902098965$6.2M

Showing top 20 of 327 providers billing this code