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

#746 of 11K

E1028

HCPCS Procedure Code

HCPCS code E1028 is the #746 most-billed Medicaid procedure code, with $90.0M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $54.00. Costs vary widely — the 90th percentile is $154.22 per claim, 2.9× the median.

Total Paid

$90.0M

0.01% of all spending

Total Claims

1.3M

Providers

569

Avg Cost/Claim

$71

National Cost Distribution

How much do providers bill per claim for E1028? Based on 568 providers billing this code nationally.

Median

$54.00

Average

$71.06

Std Dev

$67.85

Max

$459.68

Percentile Distribution (Cost per Claim)

p10
$10.84
p25
$24.55
Median
$54.00
p75
$92.29
p90
$154.22
p95
$194.36
p99
$343.74

50% of providers bill between $24.55 and $92.29 per claim for this code.

90% bill between $10.84 and $154.22.

Top 1% bill above $343.74.

About This Procedure

HCPCS code E1028 was billed by 569 providers across 1.3M claims, totaling $90.0M in Medicaid payments from 2018–2024. This code was used for 810K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$54.00

Providers Billing

568

National Spending

$90.0M

Avg/Median Ratio

1.32×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E1028

#ProviderTotal Paid
11639296817$2.7M
21891750691$2.4M
31487624193$2.4M
41114966181$2.0M
51003889684$1.7M
61932484979$1.6M
71184883472$1.5M
81043209794$1.5M
91518231547$1.1M
101912987132$1.1M
111841263621$1.1M
121093112435$1.0M
131144458209$989K
141346588225$976K
151912978669$974K
161972573137$935K
171386913937$932K
181679546519$900K
191780758219$883K
201326011263$874K

Showing top 20 of 569 providers billing this code