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

#6696 of 11K

E1354

HCPCS Procedure Code

HCPCS code E1354 is the #6,696 most-billed Medicaid procedure code, with $47K in payments across 5,881 claims from 2018–2024. The national median cost per claim is $5.14. Costs vary widely — the 90th percentile is $16.66 per claim, 3.2× the median.

Total Paid

$47K

0.00% of all spending

Total Claims

5,881

Providers

10

Avg Cost/Claim

$8

National Cost Distribution

How much do providers bill per claim for E1354? Based on 7 providers billing this code nationally.

Median

$5.14

Average

$6.97

Std Dev

$8.58

Max

$24.33

Percentile Distribution (Cost per Claim)

p10
$0.44
p25
$1.20
Median
$5.14
p75
$8.35
p90
$16.66
p95
$20.50
p99
$23.57

50% of providers bill between $1.20 and $8.35 per claim for this code.

90% bill between $0.44 and $16.66.

Top 1% bill above $23.57.

About This Procedure

HCPCS code E1354 was billed by 10 providers across 5,881 claims, totaling $47K in Medicaid payments from 2018–2024. This code was used for 4,603 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.14

Providers Billing

7

National Spending

$47K

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E1354

#ProviderTotal Paid
11548331895$40K
21447277264$4K
31639770183$1K
4Total Longterm Care Inc.

Aurora, CO · PACE Provider Organization

$950
51659757268$933
61689754046$278
71023301561$116
81558848408$0
91801063755$0
101124422183$0

Showing top 10 of 10 providers billing this code