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#5315 of 11K

E0266

HCPCS Procedure Code

HCPCS code E0266 is the #5,315 most-billed Medicaid procedure code, with $231K in payments across 4K claims from 2018–2024. The national median cost per claim is $32.99. Costs vary widely — the 90th percentile is $115.63 per claim, 3.5× the median.

Total Paid

$231K

0.00% of all spending

Total Claims

4K

Providers

11

Avg Cost/Claim

$53

National Cost Distribution

How much do providers bill per claim for E0266? Based on 11 providers billing this code nationally.

Median

$32.99

Average

$81.30

Std Dev

$136.63

Max

$475.85

Percentile Distribution (Cost per Claim)

p10
$2.15
p25
$11.84
Median
$32.99
p75
$87.17
p90
$115.63
p95
$295.74
p99
$439.83

50% of providers bill between $11.84 and $87.17 per claim for this code.

90% bill between $2.15 and $115.63.

Top 1% bill above $439.83.

About This Procedure

HCPCS code E0266 was billed by 11 providers across 4K claims, totaling $231K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$32.99

Providers Billing

11

National Spending

$231K

Avg/Median Ratio

2.46×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for E0266

#ProviderTotal Paid
11922006741$57K
21902934250$55K
31164442901$30K
41861593188$30K
5Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$25K
61093716334$22K
71871575563$9K
81942329990$2K
91851456180$1K
101306512256$292
111659480424$59

Showing top 11 of 11 providers billing this code