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

#1226 of 11K

E0973

HCPCS Procedure Code

HCPCS code E0973 is the #1,226 most-billed Medicaid procedure code, with $32.6M in payments across 653K claims from 2018–2024. The national median cost per claim is $42.75. Costs vary widely — the 90th percentile is $123.83 per claim, 2.9× the median.

Total Paid

$32.6M

0.00% of all spending

Total Claims

653K

Providers

632

Avg Cost/Claim

$50

National Cost Distribution

How much do providers bill per claim for E0973? Based on 631 providers billing this code nationally.

Median

$42.75

Average

$53.83

Std Dev

$46.44

Max

$274.99

Percentile Distribution (Cost per Claim)

p10
$5.09
p25
$14.80
Median
$42.75
p75
$78.53
p90
$123.83
p95
$147.15
p99
$186.04

50% of providers bill between $14.80 and $78.53 per claim for this code.

90% bill between $5.09 and $123.83.

Top 1% bill above $186.04.

About This Procedure

HCPCS code E0973 was billed by 632 providers across 653K claims, totaling $32.6M in Medicaid payments from 2018–2024. This code was used for 420K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.75

Providers Billing

631

National Spending

$32.6M

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0973

#ProviderTotal Paid
11639296817$1.1M
21487624193$1.0M
31932484979$847K
41043209794$790K
51497703516$764K
61518037787$749K
71346711884$738K
81891750691$716K
91003889684$712K
101114966181$567K
111841263621$434K
121972573137$400K
131184883472$388K
141144458209$366K
151912987132$365K
161982949459$356K
171518231547$340K
181912978669$332K
191386913937$326K
201053314021$317K

Showing top 20 of 632 providers billing this code