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#3250 of 11K

E1038

HCPCS Procedure Code

HCPCS code E1038 is the #3,250 most-billed Medicaid procedure code, with $2.1M in payments across 328K claims from 2018–2024. The national median cost per claim is $4.70. Costs vary widely — the 90th percentile is $14.17 per claim, 3.0× the median.

Total Paid

$2.1M

0.00% of all spending

Total Claims

328K

Providers

235

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for E1038? Based on 226 providers billing this code nationally.

Median

$4.70

Average

$8.21

Std Dev

$14.33

Max

$133.75

Percentile Distribution (Cost per Claim)

p10
$0.93
p25
$2.81
Median
$4.70
p75
$7.35
p90
$14.17
p95
$24.50
p99
$60.60

50% of providers bill between $2.81 and $7.35 per claim for this code.

90% bill between $0.93 and $14.17.

Top 1% bill above $60.60.

About This Procedure

HCPCS code E1038 was billed by 235 providers across 328K claims, totaling $2.1M in Medicaid payments from 2018–2024. This code was used for 307K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$4.70

Providers Billing

226

National Spending

$2.1M

Avg/Median Ratio

1.75×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for E1038

#ProviderTotal Paid
1Apria Healthcare Llc

Indianapolis, IN · Durable Medical Equipment & Medical Supplies

$653K
2Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$108K
31730182023$90K
41093716334$89K
51538669163$73K
6H & H Drug Stores, Inc

Glendale, CA · Durable Medical Equipment & Medical Supplies

$59K
71023017647$52K
81063710986$51K
91447277264$47K
10Super Care Inc

City Of Industry, CA · Durable Medical Equipment & Medical Supplies

$47K
111922046085$43K
12Medcare Equipment Company, Llc

Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies

$34K
131386688414$30K
141053314021$30K
151629072665$28K
161871575563$27K
171427153626$25K
181285772343$21K
191437154713$20K
201790881530$17K

Showing top 20 of 235 providers billing this code