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#4203 of 11K

E1260

HCPCS Procedure Code

HCPCS code E1260 is the #4,203 most-billed Medicaid procedure code, with $755K in payments across 4,585 claims from 2018–2024. The national median cost per claim is $114.27. Costs vary widely — the 90th percentile is $644.21 per claim, 5.6× the median.

Total Paid

$755K

0.00% of all spending

Total Claims

4,585

Providers

9

Avg Cost/Claim

$165

National Cost Distribution

How much do providers bill per claim for E1260? Based on 8 providers billing this code nationally.

Median

$114.27

Average

$222.67

Std Dev

$273.26

Max

$671.47

Percentile Distribution (Cost per Claim)

p10
$5.17
p25
$29.22
Median
$114.27
p75
$309.22
p90
$644.21
p95
$657.84
p99
$668.74

50% of providers bill between $29.22 and $309.22 per claim for this code.

90% bill between $5.17 and $644.21.

Top 1% bill above $668.74.

About This Procedure

HCPCS code E1260 was billed by 9 providers across 4,585 claims, totaling $755K in Medicaid payments from 2018–2024. This code was used for 4,130 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$114.27

Providers Billing

8

National Spending

$755K

Avg/Median Ratio

1.95×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for E1260

#ProviderTotal Paid
11144371204$337K
21053314021$275K
31669570172$105K
41114993490$14K
51710985718$12K
61376612895$10K
71922088129$2K
81407836133$2K
91912199415$0

Showing top 9 of 9 providers billing this code

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