#5781 of 11K

E0159

HCPCS Procedure Code

HCPCS code E0159 is the #5,781 most-billed Medicaid procedure code, with $140K in payments across 19K claims from 2018–2024. The national median cost per claim is $6.69. Costs vary widely — the 90th percentile is $15.25 per claim, 2.3× the median.

Total Paid

$140K

0.00% of all spending

Total Claims

19K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for E0159? Based on 31 providers billing this code nationally.

Median

$6.69

Average

$7.12

Std Dev

$5.36

Max

$18.44

Percentile Distribution (Cost per Claim)

p10

$1.35

p25

$2.27

Median

$6.69

p75

$10.72

p90

$15.25

p95

$16.85

p99

$18.24

50% of providers bill between $2.27 and $10.72 per claim for this code.

90% bill between $1.35 and $15.25.

Top 1% bill above $18.24.

About This Procedure

HCPCS code E0159 was billed by 35 providers across 19K claims, totaling $140K in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.69

Providers Billing

National Spending

$140K

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0159

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1053314021	$60K	$11.89	1.8× median	Above 75th
2	Home Medical Equipment Specialists Llc Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$13K	$7.56	1.1× median	Above Median
3	1922006741	$12K	$15.25	2.3× median	Top 10%
4	1831200294	$10K	$9.12	1.4× median	Above Median
5	1235372848	$8K	$6.13	0.9× median	Below Median
6	1689665911	$7K	$15.94	2.4× median	Top 10%
7	1427339530	$6K	$1.35	0.2× median	Below Median
8	1801183272	$6K	$10.48	1.6× median	Above Median
9	1699767061	$3K	$3.86	0.6× median	Below Median
10	1235389347	$3K	$10.60	1.6× median	Above Median
11	1972500940	$2K	$17.76	2.7× median	Top 10%
12	1154479913	$2K	$7.54	1.1× median	Above Median
13	1184716672	$2K	$9.36	1.4× median	Above Median
14	1215997853	$1K	$4.83	0.7× median	Below Median
15	1114993490	$1K	$1.49	0.2× median	Below Median
16	1568464295	$865	$2.12	0.3× median	Below Median
17	1548336423	$793	$18.44	2.8× median	Top 1%
18	1144221797	$629	$6.69	1.0× median	Below Median
19	1619913357	$401	$10.84	1.6× median	Above 75th
20	Integra Partners Llc Troy, MI · Orthotic Fitter	$309	$3.19	0.5× median	Below Median

Showing top 20 of 35 providers billing this code

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E0163$15.8M E0156$4.7M E0149$4.0M E0165$1.7M E0168$547K

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