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#1660 of 11K

E0971

HCPCS Procedure Code

HCPCS code E0971 is the #1,660 most-billed Medicaid procedure code, with $16.7M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $13.46. Costs vary widely — the 90th percentile is $51.80 per claim, 3.8× the median.

Total Paid

$16.7M

0.00% of all spending

Total Claims

1.0M

Providers

809

Avg Cost/Claim

$16

National Cost Distribution

How much do providers bill per claim for E0971? Based on 804 providers billing this code nationally.

Median

$13.46

Average

$21.99

Std Dev

$21.42

Max

$124.77

Percentile Distribution (Cost per Claim)

p10
$1.63
p25
$3.88
Median
$13.46
p75
$36.62
p90
$51.80
p95
$63.21
p99
$78.06

50% of providers bill between $3.88 and $36.62 per claim for this code.

90% bill between $1.63 and $51.80.

Top 1% bill above $78.06.

About This Procedure

HCPCS code E0971 was billed by 809 providers across 1.0M claims, totaling $16.7M in Medicaid payments from 2018–2024. This code was used for 671K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.46

Providers Billing

804

National Spending

$16.7M

Avg/Median Ratio

1.63×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for E0971

#ProviderTotal Paid
1Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$625K
21639296817$453K
31346711884$376K
41518037787$372K
51043209794$332K
61932484979$291K
71891750691$278K
81003889684$241K
91114966181$227K
101326077249$226K
111184883472$207K
12H & H Drug Stores, Inc

Glendale, CA · Durable Medical Equipment & Medical Supplies

$206K
131487624193$203K
141841263621$168K
151982949459$158K
16Integra Partners Llc

Troy, MI · Orthotic Fitter

$156K
171497703516$155K
181003052598$154K
191346588225$147K
201144458209$142K

Showing top 20 of 809 providers billing this code