#2305 of 11K

E0604

HCPCS Procedure Code

HCPCS code E0604 is the #2,305 most-billed Medicaid procedure code, with $6.9M in payments across 183K claims from 2018–2024. The national median cost per claim is $48.56.

Total Paid

$6.9M

0.00% of all spending

Total Claims

183K

Providers

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for E0604? Based on 68 providers billing this code nationally.

Median

$48.56

Average

$49.37

Std Dev

$29.53

Max

$155.34

Percentile Distribution (Cost per Claim)

p10

$18.38

p25

$30.86

Median

$48.56

p75

$64.11

p90

$71.67

p95

$101.89

p99

$144.45

50% of providers bill between $30.86 and $64.11 per claim for this code.

90% bill between $18.38 and $71.67.

Top 1% bill above $144.45.

About This Procedure

HCPCS code E0604 was billed by 70 providers across 183K claims, totaling $6.9M in Medicaid payments from 2018–2024. This code was used for 177K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$48.56

Providers Billing

National Spending

$6.9M

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for E0604

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$2.7M	$30.27	0.6× median	Below Median
2	1275687840	$1.1M	$56.86	1.2× median	Above Median
3	1790871655	$476K	$61.02	1.3× median	Above Median
4	1306961511	$301K	$51.93	1.1× median	Above Median
5	1972500940	$277K	$57.64	1.2× median	Above Median
6	1215997853	$240K	$69.60	1.4× median	Above 75th
7	Home Medical Equipment Specialists Llc Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$218K	$69.39	1.4× median	Above 75th
8	1477868446	$184K	$62.61	1.3× median	Above Median
9	1689665911	$158K	$46.63	1.0× median	Below Median
10	1417955170	$82K	$39.18	0.8× median	Below Median
11	1629505607	$78K	$59.60	1.2× median	Above Median
12	1285642025	$75K	$42.11	0.9× median	Below Median
13	1275553968	$66K	$64.81	1.3× median	Above 75th
14	1316126931	$60K	$155.34	3.2× median	Top 1%
15	1477611283	$57K	$49.72	1.0× median	Above Median
16	1700019908	$50K	$54.63	1.1× median	Above Median
17	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$43K	$10.81	0.2× median	Below Median
18	Integra Partners Llc Troy, MI · Orthotic Fitter	$41K	$51.93	1.1× median	Above Median
19	Multicare Health System Tacoma, WA · Community/Behavioral Health	$36K	$30.79	0.6× median	Below Median
20	1134112659	$35K	$47.94	1.0× median	Below Median

Showing top 20 of 70 providers billing this code

Related Procedures

E0601Continuous positive airway pressure (CPAP) device$564.5M E0603Breast pump, electric, any type$418.9M E0600$24.1M E0607$5.0M E0602Breast pump, manual, each$126K

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