E1226
HCPCS Procedure Code
HCPCS code E1226 is the #3,093 most-billed Medicaid procedure code, with $2.5M in payments across 76K claims from 2018–2024. The national median cost per claim is $29.99. Costs vary widely — the 90th percentile is $70.44 per claim, 2.3× the median.
Total Paid
$2.5M
0.00% of all spending
Total Claims
76K
Providers
101
Avg Cost/Claim
$33
National Cost Distribution
How much do providers bill per claim for E1226? Based on 98 providers billing this code nationally.
Median
$29.99
Average
$40.01
Std Dev
$47.10
Max
$323.05
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.64 and $46.63 per claim for this code.
90% bill between $9.41 and $70.44.
Top 1% bill above $311.38.
About This Procedure
HCPCS code E1226 was billed by 101 providers across 76K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 70K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$29.99
Providers Billing
98
National Spending
$2.5M
Avg/Median Ratio
1.33×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for E1226
| # | Provider | Total Paid |
|---|---|---|
| 1 | Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier | $387K |
| 2 | Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies | $285K |
| 3 | 1386688414 | $280K |
| 4 | H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies | $237K |
| 5 | 1730182023 | $97K |
| 6 | 1497703516 | $95K |
| 7 | 1851328157 | $72K |
| 8 | 1922046085 | $69K |
| 9 | 1093716334 | $65K |
| 10 | 1518037787 | $59K |
| 11 | 1073692794 | $53K |
| 12 | 1164486445 | $43K |
| 13 | 1326077249 | $42K |
| 14 | 1285803775 | $40K |
| 15 | 1043800469 | $36K |
| 16 | 1801866173 | $34K |
| 17 | 1245387943 | $34K |
| 18 | 1316018070 | $29K |
| 19 | 1255632394 | $27K |
| 20 | 1083612022 | $27K |
Showing top 20 of 101 providers billing this code