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

#4978 of 11K

E1290

HCPCS Procedure Code

HCPCS code E1290 is the #4,978 most-billed Medicaid procedure code, with $332K in payments across 2,131 claims from 2018–2024. The national median cost per claim is $33.64. Costs vary widely — the 90th percentile is $252.30 per claim, 7.5× the median.

Total Paid

$332K

0.00% of all spending

Total Claims

2,131

Providers

4

Avg Cost/Claim

$156

National Cost Distribution

How much do providers bill per claim for E1290? Based on 4 providers billing this code nationally.

Median

$33.64

Average

$105.24

Std Dev

$160.67

Max

$345.56

Percentile Distribution (Cost per Claim)

p10
$15.45
p25
$26.47
Median
$33.64
p75
$112.41
p90
$252.30
p95
$298.93
p99
$336.23

50% of providers bill between $26.47 and $112.41 per claim for this code.

90% bill between $15.45 and $252.30.

Top 1% bill above $336.23.

About This Procedure

HCPCS code E1290 was billed by 4 providers across 2,131 claims, totaling $332K in Medicaid payments from 2018–2024. This code was used for 1,848 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$33.64

Providers Billing

4

National Spending

$332K

Avg/Median Ratio

3.13×

Highly skewed — outlier-driven

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.