#2953 of 11K

E0986

HCPCS Procedure Code

HCPCS code E0986 is the #2,953 most-billed Medicaid procedure code, with $3.0M in payments across 3,162 claims from 2018–2024. The national median cost per claim is $945.66. Costs vary widely — the 90th percentile is $2,189.68 per claim, 2.3× the median.

Total Paid

$3.0M

0.00% of all spending

Total Claims

3,162

Providers

Avg Cost/Claim

$933

National Cost Distribution

How much do providers bill per claim for E0986? Based on 20 providers billing this code nationally.

Median

$945.66

Average

$1,226.66

Std Dev

$947.40

Max

$3,981.37

Percentile Distribution (Cost per Claim)

p10

$374.60

p25

$554.23

Median

$945.66

p75

$1,502.09

p90

$2,189.68

p95

$3,000.64

p99

$3,785.23

50% of providers bill between $554.23 and $1,502.09 per claim for this code.

90% bill between $374.60 and $2,189.68.

Top 1% bill above $3,785.23.

About This Procedure

HCPCS code E0986 was billed by 20 providers across 3,162 claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 2,793 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$945.66

Providers Billing

National Spending

$3.0M

Avg/Median Ratio

1.30×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0986

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1780758219	$530K	$903.32	1.0× median	Below Median
2	1568475341	$448K	$891.18	0.9× median	Below Median
3	1578531356	$337K	$698.55	0.7× median	Below Median
4	1003889684	$269K	$2,105.31	2.2× median	Above 75th
5	1114966181	$265K	$2,949.02	3.1× median	Top 10%
6	1487624193	$242K	$1,397.56	1.5× median	Above Median
7	1144458209	$138K	$1,451.12	1.5× median	Above Median
8	1003156274	$112K	$489.53	0.5× median	Below Median
9	1891750691	$107K	$3,981.37	4.2× median	Top 1%
10	1588732812	$104K	$575.80	0.6× median	Below Median
11	1346588225	$80K	$1,232.23	1.3× median	Above Median
12	1326011263	$69K	$1,389.04	1.5× median	Above Median
13	1912949702	$68K	$384.49	0.4× median	Below Median
14	1043209794	$41K	$988.00	1.0× median	Above Median
15	1699845883	$35K	$169.17	0.2× median	Below Median
16	1184883472	$29K	$1,822.82	1.9× median	Above 75th
17	1841263621	$29K	$676.29	0.7× median	Below Median
18	1710984869	$22K	$1,654.99	1.8× median	Above 75th
19	1538576509	$21K	$487.80	0.5× median	Below Median
20	1598812232	$5K	$285.63	0.3× median	Below Median

Showing top 20 of 20 providers billing this code

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