#2345 of 11K

E1236

HCPCS Procedure Code

HCPCS code E1236 is the #2,345 most-billed Medicaid procedure code, with $6.5M in payments across 24K claims from 2018–2024. The national median cost per claim is $389.45. Costs vary widely — the 90th percentile is $1,302.06 per claim, 3.3× the median.

Total Paid

$6.5M

0.00% of all spending

Total Claims

24K

Providers

Avg Cost/Claim

$278

National Cost Distribution

How much do providers bill per claim for E1236? Based on 55 providers billing this code nationally.

Median

$389.45

Average

$568.94

Std Dev

$499.89

Max

$1,736.35

Percentile Distribution (Cost per Claim)

p10

$99.94

p25

$166.22

Median

$389.45

p75

$1,009.42

p90

$1,302.06

p95

$1,497.03

p99

$1,673.03

50% of providers bill between $166.22 and $1,009.42 per claim for this code.

90% bill between $99.94 and $1,302.06.

Top 1% bill above $1,673.03.

About This Procedure

HCPCS code E1236 was billed by 55 providers across 24K claims, totaling $6.5M in Medicaid payments from 2018–2024. This code was used for 22K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$389.45

Providers Billing

National Spending

$6.5M

Avg/Median Ratio

1.46×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E1236

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1326011263	$923K	$965.00	2.5× median	Above Median
2	1407894348	$857K	$129.68	0.3× median	Below Median
3	1497703516	$725K	$154.71	0.4× median	Below Median
4	1366580391	$477K	$538.58	1.4× median	Above Median
5	1487624193	$349K	$1,473.30	3.8× median	Top 10%
6	1609858752	$340K	$1,230.68	3.2× median	Above 75th
7	1184883472	$314K	$1,358.22	3.5× median	Top 10%
8	1841263621	$228K	$445.51	1.1× median	Above Median
9	1528037538	$215K	$159.02	0.4× median	Below Median
10	1003052598	$165K	$1,619.08	4.2× median	Top 10%
11	1093112435	$158K	$1,053.84	2.7× median	Above 75th
12	1477526333	$138K	$1,552.40	4.0× median	Top 10%
13	1326431404	$129K	$1,256.05	3.2× median	Above 75th
14	Binson's Hospital Supplies, Inc. Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment	$129K	$389.45	1.0× median	Below Median
15	1215947346	$124K	$173.42	0.4× median	Below Median
16	1386073369	$106K	$395.85	1.0× median	Above Median
17	1013072214	$94K	$103.06	0.3× median	Below Median
18	1932484979	$88K	$1,287.55	3.3× median	Above 75th
19	1780758219	$79K	$1,115.31	2.9× median	Above 75th
20	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$71K	$445.89	1.1× median	Above Median

Showing top 20 of 55 providers billing this code

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