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#7625 of 11K

E0974

HCPCS Procedure Code

HCPCS code E0974 is the #7,625 most-billed Medicaid procedure code, with $13K in payments across 2,082 claims from 2018–2024. The national median cost per claim is $5.37. Costs vary widely — the 90th percentile is $57.81 per claim, 10.8× the median.

Total Paid

$13K

0.00% of all spending

Total Claims

2,082

Providers

6

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for E0974? Based on 5 providers billing this code nationally.

Median

$5.37

Average

$23.83

Std Dev

$30.26

Max

$69.96

Percentile Distribution (Cost per Claim)

p10
$1.88
p25
$3.20
Median
$5.37
p75
$39.60
p90
$57.81
p95
$63.88
p99
$68.74

50% of providers bill between $3.20 and $39.60 per claim for this code.

90% bill between $1.88 and $57.81.

Top 1% bill above $68.74.

About This Procedure

HCPCS code E0974 was billed by 6 providers across 2,082 claims, totaling $13K in Medicaid payments from 2018–2024. This code was used for 1,398 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.37

Providers Billing

5

National Spending

$13K

Avg/Median Ratio

4.44×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for E0974

#ProviderTotal Paid
11023232501$4K
21306961792$3K
31477138386$3K
41427339530$2K
51306829197$419
61659008159$0

Showing top 6 of 6 providers billing this code