E0961
HCPCS Procedure Code
HCPCS code E0961 is the #3,039 most-billed Medicaid procedure code, with $2.7M in payments across 238K claims from 2018–2024. The national median cost per claim is $10.99. Costs vary widely — the 90th percentile is $31.66 per claim, 2.9× the median.
Total Paid
$2.7M
0.00% of all spending
Total Claims
238K
Providers
280
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for E0961? Based on 280 providers billing this code nationally.
Median
$10.99
Average
$14.63
Std Dev
$12.90
Max
$58.48
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.79 and $23.32 per claim for this code.
90% bill between $1.06 and $31.66.
Top 1% bill above $56.22.
About This Procedure
HCPCS code E0961 was billed by 280 providers across 238K claims, totaling $2.7M in Medicaid payments from 2018–2024. This code was used for 152K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.99
Providers Billing
280
National Spending
$2.7M
Avg/Median Ratio
1.33×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for E0961
| # | Provider | Total Paid |
|---|---|---|
| 1 | Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier | $205K |
| 2 | 1639296817 | $176K |
| 3 | 1326077249 | $141K |
| 4 | 1518037787 | $127K |
| 5 | 1891750691 | $112K |
| 6 | 1114966181 | $97K |
| 7 | 1932484979 | $80K |
| 8 | 1730182023 | $64K |
| 9 | 1184883472 | $62K |
| 10 | 1841263621 | $61K |
| 11 | 1982949459 | $59K |
| 12 | 1487624193 | $57K |
| 13 | 1407497977 | $54K |
| 14 | 1093716334 | $51K |
| 15 | 1003889684 | $47K |
| 16 | Integra Partners Llc Troy, MI · Orthotic Fitter | $39K |
| 17 | 1659361947 | $36K |
| 18 | 1346711884 | $36K |
| 19 | 1144458209 | $35K |
| 20 | 1053314021 | $35K |
Showing top 20 of 280 providers billing this code