| Code | Description | States | Median rate |
|---|---|---|---|
| E0100 | Cane, includes canes of all materials, adjustable or fixed, with tip | 44 | $24.03 |
| E0105 | Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips | 44 | $56.00 |
| E0110 | Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips | 43 | $88.46 |
| E0111 | Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips | 41 | $60.70 |
| E0112 | Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips | 43 | $40.35 |
| E0113 | Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip | 42 | $24.61 |
| E0114 | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips | 44 | $51.52 |
| E0116 | Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each | 41 | $29.18 |
| E0117 | Crutch, underarm, articulating, spring assisted, each | 26 | $216.34 |
| E0130 | Walker, rigid (pickup), adjustable or fixed height | 44 | $56.58 |
| E0135 | Walker, folding (pickup), adjustable or fixed height | 44 | $54.56 |
| E0140 | Walker, with trunk support, adjustable or fixed height, any type | 36 | $346.61 |
| E0141 | Walker, rigid, wheeled, adjustable or fixed height | 43 | $60.57 |
| E0143 | Walker, folding, wheeled, adjustable or fixed height | 44 | $59.54 |
| E0144 | Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat | 31 | $292.06 |
| E0147 | Walker, heavy duty, multiple braking system, variable wheel resistance | 39 | $467.26 |
| E0148 | Walker, heavy duty, without wheels, rigid or folding, any type, each | 42 | $104.34 |
| E0149 | Walker, heavy duty, wheeled, rigid or folding, any type | 44 | $165.15 |
| E0153 | Platform attachment, forearm crutch, each | 44 | $66.82 |
| E0154 | Platform attachment, walker, each | 42 | $57.53 |
| E0155 | Wheel attachment, rigid pick-up walker, per pair | 43 | $25.72 |
| E0156 | Seat attachment, walker | 40 | $19.63 |
| E0157 | Crutch attachment, walker, each | 40 | $64.58 |
| E0158 | Leg extensions for walker, per set of four (4) | 40 | $26.04 |
| E0159 | Brake attachment for wheeled walker, replacement, each | 37 | $16.35 |
| E0160 | Sitz type bath or equipment, portable, used with or without commode | 33 | $32.10 |
| E0161 | Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s | 30 | $27.33 |
| E0162 | Sitz bath chair | 24 | $158.85 |
| E0163 | Commode chair, mobile or stationary, with fixed arms | 45 | $65.26 |
| E0165 | Commode chair, mobile or stationary, with detachable arms | 44 | $153.90 |
| E0167 | Pail or pan for use with commode chair, replacement only | 42 | $11.08 |
| E0168 | Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each | 43 | $137.84 |
| E0170 | Commode chair with integrated seat lift mechanism, electric, any type | 20 | $514.49 |
| E0171 | Commode chair with integrated seat lift mechanism, non-electric, any type | 20 | $304.80 |
| E0175 | Foot rest, for use with commode chair, each | 34 | $67.01 |
| E0181 | Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty | 44 | $194.80 |
| E0182 | Pump for alternating pressure pad, for replacement only | 40 | $212.14 |
| E0183 | Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty | 21 | $202.15 |
| E0184 | Dry pressure mattress | 44 | $182.26 |
| E0185 | Gel or gel-like pressure pad for mattress, standard mattress length and width | 45 | $208.13 |
| E0186 | Air pressure mattress | 42 | $179.28 |
| E0187 | Water pressure mattress | 38 | $219.50 |
| E0188 | Synthetic sheepskin pad | 39 | $27.47 |
| E0189 | Lambswool sheepskin pad, any size | 38 | $57.17 |
| E0190 | Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories | 19 | $38.99 |
| E0191 | Heel or elbow protector, each | 42 | $9.72 |
| E0193 | Powered air flotation bed (low air loss therapy) | 32 | $6,000.00 |
| E0194 | Air fluidized bed | 32 | $15,242.19 |
| E0196 | Gel pressure mattress | 41 | $287.60 |
| E0197 | Air pressure pad for mattress, standard mattress length and width | 42 | $196.75 |
| E0198 | Water pressure pad for mattress, standard mattress length and width | 40 | $190.52 |
| E0199 | Dry pressure pad for mattress, standard mattress length and width | 41 | $30.84 |
| E0200 | Heat lamp, without stand (table model), includes bulb, or infrared element | 26 | $80.35 |
| E0202 | Phototherapy (bilirubin) light with photometer | 41 | $68.50 |
| E0205 | Heat lamp, with stand, includes bulb, or infrared element | 25 | $180.95 |
| E0210 | Electric heat pad, standard | 24 | $38.36 |
| E0215 | Electric heat pad, moist | 23 | $67.86 |
| E0217 | Water circulating heat pad with pump | 29 | $478.05 |
| E0221 | Infrared heating pad system | 10 | $1,957.52 |
| E0225 | Hydrocollator unit, includes pads | 17 | $370.53 |
| E0235 | Paraffin bath unit, portable (see medical supply code a4265 for paraffin) | 29 | $155.40 |
| E0236 | Pump for water circulating pad | 23 | $358.90 |
| E0239 | Hydrocollator unit, portable | 15 | $529.56 |
| E0240 | Bath/shower chair, with or without wheels, any size | 21 | $83.54 |
| E0241 | Bath tub wall rail, each | 21 | $25.03 |
| E0242 | Bath tub rail, floor base | 11 | $40.00 |
| E0243 | Toilet rail, each | 24 | $37.24 |
| E0244 | Raised toilet seat | 29 | $44.69 |
| E0245 | Tub stool or bench | 27 | $56.84 |
| E0246 | Transfer tub rail attachment | 21 | $49.64 |
| E0247 | Transfer bench for tub or toilet with or without commode opening | 21 | $90.73 |
| E0248 | Transfer bench, heavy duty, for tub or toilet with or without commode opening | 19 | $159.07 |
| E0249 | Pad for water circulating heat unit, for replacement only | 24 | $93.68 |
| E0250 | Hospital bed, fixed height, with any type side rails, with mattress | 41 | $700.00 |
| E0251 | Hospital bed, fixed height, with any type side rails, without mattress | 34 | $526.89 |
| E0255 | Hospital bed, variable height, hi-lo, with any type side rails, with mattress | 41 | $704.75 |
| E0256 | Hospital bed, variable height, hi-lo, with any type side rails, without mattress | 34 | $610.89 |
| E0260 | Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress | 42 | $767.40 |
| E0261 | Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress | 38 | $666.10 |
| E0265 | Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress | 34 | $1,685.82 |
| E0266 | Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress | 31 | $1,305.05 |
| E0271 | Mattress, innerspring | 44 | $140.07 |
| E0272 | Mattress, foam rubber | 42 | $144.85 |
| E0274 | Over-bed table | 10 | $134.59 |
| E0275 | Bed pan, standard, metal or plastic | 37 | $14.21 |
| E0276 | Bed pan, fracture, metal or plastic | 41 | $12.00 |
| E0277 | Powered pressure-reducing air mattress | 38 | $1,675.50 |
| E0280 | Bed cradle, any type | 28 | $37.04 |
| E0290 | Hospital bed, fixed height, without side rails, with mattress | 33 | $629.37 |
| E0291 | Hospital bed, fixed height, without side rails, without mattress | 34 | $457.21 |
| E0292 | Hospital bed, variable height, hi-lo, without side rails, with mattress | 31 | $720.33 |
| E0293 | Hospital bed, variable height, hi-lo, without side rails, without mattress | 32 | $602.18 |
| E0294 | Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress | 32 | $763.15 |
| E0295 | Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress | 34 | $746.45 |
| E0296 | Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress | 26 | $1,407.38 |
| E0297 | Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress | 26 | $1,172.88 |
| E0300 | Pediatric crib, hospital grade, fully enclosed, with or without top enclosure | 27 | $2,723.31 |
| E0301 | Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress | 34 | $1,845.20 |
| E0302 | Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress | 33 | $4,578.80 |
| E0303 | Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress | 42 | $1,897.62 |
| E0304 | Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, with mattress | 39 | $4,290.79 |
| E0305 | Bed side rails, half length | 40 | $134.34 |
| E0310 | Bed side rails, full length | 43 | $130.79 |
| E0315 | Bed accessory: board, table, or support device, any type | 10 | $82.24 |
| E0316 | Safety enclosure frame/canopy for use with hospital bed, any type | 25 | $1,728.42 |
| E0325 | Urinal; male, jug-type, any material | 40 | $9.32 |
| E0326 | Urinal; female, jug-type, any material | 40 | $9.92 |
| E0370 | Air pressure elevator for heel | 10 | $21.27 |
| E0371 | Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width | 31 | $1,850.16 |
| E0372 | Powered air overlay for mattress, standard mattress length and width | 31 | $2,020.01 |
| E0373 | Nonpowered advanced pressure reducing mattress | 30 | $2,192.16 |
| E0424 | Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing | 42 | $101.00 |
| E0430 | Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing | 11 | $211.16 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | 40 | $26.49 |
| E0433 | Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge | 22 | $43.29 |
| E0434 | Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing | 39 | $43.29 |
| E0435 | Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor | 10 | $75.00 |
| E0439 | Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing | 39 | $139.30 |
| E0441 | Stationary oxygen contents, gaseous, 1 month's supply = 1 unit | 39 | $65.61 |
| E0442 | Stationary oxygen contents, liquid, 1 month's supply = 1 unit | 37 | $65.39 |
| E0443 | Portable oxygen contents, gaseous, 1 month's supply = 1 unit | 40 | $57.56 |
| E0444 | Portable oxygen contents, liquid, 1 month's supply = 1 unit | 37 | $57.56 |
| E0445 | Oximeter device for measuring blood oxygen levels non-invasively | 36 | $585.62 |
| E0447 | Portable oxygen contents, liquid, 1 month's supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm) | 27 | $84.53 |
| E0455 | Oxygen tent, excluding croup or pediatric tents | 16 | $23.99 |
| E0457 | Chest shell (cuirass) | 25 | $587.89 |
| E0459 | Chest wrap | 22 | $352.00 |
| E0462 | Rocking bed with or without side rails | 18 | $3,220.75 |
| E0465 | Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) | 42 | $1,022.90 |
| E0466 | Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) | 42 | $982.84 |
| E0467 | Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions | 30 | $1,161.36 |
| E0468 | Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions | 18 | $1,040.37 |
| E0469 | Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device | 18 | $8,945.36 |
| E0470 | Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) | 43 | $1,339.40 |
| E0471 | Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) | 43 | $2,501.60 |
| E0472 | Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device) | 36 | $1,951.29 |
| E0480 | Percussor, electric or pneumatic, home model | 42 | $377.46 |
| E0482 | Cough stimulating device, alternating positive and negative airway pressure | 42 | $4,050.00 |
| E0483 | High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each | 42 | $12,207.03 |
| E0484 | Oscillatory positive expiratory pressure device, non-electric, any type, each | 34 | $42.11 |
| E0500 | Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source | 35 | $660.04 |
| E0550 | Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery | 37 | $350.00 |
| E0555 | Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter | 26 | $15.00 |
| E0560 | Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery | 31 | $144.08 |
| E0561 | Humidifier, non-heated, used with positive airway pressure device | 43 | $87.53 |
| E0562 | Humidifier, heated, used with positive airway pressure device | 44 | $172.12 |
| E0565 | Compressor, air power source for equipment which is not self-contained or cylinder driven | 44 | $446.33 |
| E0570 | Nebulizer, with compressor | 45 | $106.77 |
| E0572 | Aerosol compressor, adjustable pressure, light duty for intermittent use | 24 | $295.12 |
| E0574 | Ultrasonic/electronic aerosol generator with small volume nebulizer | 27 | $385.82 |
| E0575 | Nebulizer, ultrasonic, large volume | 31 | $802.94 |
| E0580 | Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter | 32 | $131.72 |
| E0585 | Nebulizer, with compressor and heater | 37 | $276.40 |
| E0600 | Respiratory suction pump, home model, portable or stationary, electric | 44 | $398.25 |
| E0601 | Continuous positive airway pressure (cpap) device | 43 | $504.08 |
| E0602 | Breast pump, manual, any type | 36 | $33.10 |
| E0603 | Breast pump, electric (ac and/or dc), any type | 38 | $138.65 |
| E0604 | Breast pump, hospital grade, electric (ac and / or dc), any type | 23 | $56.21 |
| E0605 | Vaporizer, room type | 30 | $28.54 |
| E0606 | Postural drainage board | 30 | $241.30 |
| E0607 | Home blood glucose monitor | 30 | $79.82 |
| E0610 | Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems) | 23 | $289.29 |
| E0615 | Pacemaker monitor, self contained, checks battery depletion and other pacemaker components, includes digital/visible check systems | 22 | $521.17 |
| E0617 | External defibrillator with integrated electrocardiogram analysis | 23 | $2,972.39 |
| E0618 | Apnea monitor, without recording feature | 28 | $2,131.27 |
| E0619 | Apnea monitor, with recording feature | 37 | $281.77 |
| E0620 | Skin piercing device for collection of capillary blood, laser, each | 10 | $903.21 |
| E0621 | Sling or seat, patient lift, canvas or nylon | 44 | $89.96 |
| E0627 | Seat lift mechanism, electric, any type | 28 | $315.47 |
| E0629 | Seat lift mechanism, non-electric, any type | 26 | $299.08 |
| E0630 | Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) | 45 | $747.10 |
| E0635 | Patient lift, electric with seat or sling | 36 | $1,191.81 |
| E0636 | Multipositional patient support system, with integrated lift, patient accessible controls | 19 | $5,204.43 |
| E0637 | Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels | 21 | $2,173.62 |
| E0638 | Standing frame/table system, one position (e.g., upright, supine or prone stander), any size including pediatric, with or without wheels | 24 | $1,389.28 |
| E0639 | Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories | 20 | $1,352.56 |
| E0640 | Patient lift, fixed system, includes all components/accessories | 14 | $1,129.75 |
| E0641 | Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels | 13 | $2,912.40 |
| E0650 | Pneumatic compressor, non-segmental home model | 38 | $764.97 |
| E0651 | Pneumatic compressor, segmental home model without calibrated gradient pressure | 39 | $966.92 |
| E0652 | Pneumatic compressor, segmental home model with calibrated gradient pressure | 37 | $5,973.78 |
| E0655 | Non-segmental pneumatic appliance for use with pneumatic compressor, half arm | 38 | $113.08 |
| E0656 | Segmental pneumatic appliance for use with pneumatic compressor, trunk | 23 | $603.91 |
| E0657 | Segmental pneumatic appliance for use with pneumatic compressor, chest | 22 | $567.04 |
| E0658 | Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest | 15 | $1,439.05 |
| E0659 | Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest | 14 | $1,439.05 |
| E0660 | Non-segmental pneumatic appliance for use with pneumatic compressor, full leg | 38 | $156.10 |
| E0665 | Non-segmental pneumatic appliance for use with pneumatic compressor, full arm | 38 | $132.77 |
| E0666 | Non-segmental pneumatic appliance for use with pneumatic compressor, half leg | 37 | $132.97 |
| E0667 | Segmental pneumatic appliance for use with pneumatic compressor, full leg | 39 | $344.46 |
| E0668 | Segmental pneumatic appliance for use with pneumatic compressor, full arm | 39 | $428.22 |
| E0669 | Segmental pneumatic appliance for use with pneumatic compressor, half leg | 36 | $198.21 |
| E0670 | Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk | 29 | $1,387.74 |
| E0671 | Segmental gradient pressure pneumatic appliance, full leg | 35 | $447.43 |
| E0672 | Segmental gradient pressure pneumatic appliance, full arm | 34 | $360.72 |
| E0673 | Segmental gradient pressure pneumatic appliance, half leg | 34 | $289.61 |
| E0675 | Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system) | 20 | $548.03 |
| E0677 | Non-pneumatic sequential compression garment, trunk | 15 | $589.41 |
| E0678 | Non-pneumatic sequential compression garment, full leg | 19 | $345.21 |
| E0679 | Non-pneumatic sequential compression garment, half leg | 19 | $199.52 |
| E0680 | Non-pneumatic compression controller with sequential calibrated gradient pressure | 19 | $5,046.00 |
| E0681 | Non-pneumatic compression controller without calibrated gradient pressure | 17 | $979.15 |
| E0682 | Non-pneumatic sequential compression garment, full arm | 20 | $439.13 |
| E0683 | Non-pneumatic, non-sequential, peristaltic wave compression pump | 15 | $639.44 |
| E0691 | Ultraviolet light therapy system, includes bulbs/lamps, timer and eye protection; treatment area 2 square feet or less | 19 | $1,024.49 |
| E0692 | Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel | 18 | $1,317.23 |
| E0693 | Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel | 17 | $1,693.27 |
| E0694 | Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection | 18 | $5,047.66 |
| E0700 | Safety equipment, device or accessory, any type | 12 | $48.10 |
| E0705 | Transfer device, any type, each | 38 | $47.66 |
| E0710 | Restraints, any type (body, chest, wrist or ankle) | 11 | $14.40 |
| E0720 | Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation | 35 | $83.52 |
| E0730 | Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation | 36 | $83.22 |
| E0731 | Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) | 26 | $107.30 |
| E0733 | Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve | 11 | $51.36 |
| E0735 | Non-invasive vagus nerve stimulator | 11 | $280.00 |
| E0740 | Non-implanted pelvic floor electrical stimulator, complete system | 19 | $584.48 |
| E0743 | External lower extremity nerve stimulator for restless legs syndrome, each | 11 | $1,642.37 |
| E0744 | Neuromuscular stimulator for scoliosis | 21 | $871.81 |
| E0745 | Neuromuscular stimulator, electronic shock unit | 26 | $864.02 |
| E0747 | Osteogenesis stimulator, electrical, non-invasive, other than spinal applications | 40 | $3,791.12 |
| E0748 | Osteogenesis stimulator, electrical, non-invasive, spinal applications | 38 | $4,435.84 |
| E0749 | Osteogenesis stimulator, electrical, surgically implanted | 11 | $2,206.35 |
| E0760 | Osteogenesis stimulator, low intensity ultrasound, non-invasive | 33 | $3,607.61 |
| E0762 | Transcutaneous electrical joint stimulation device system, includes all accessories | 15 | $896.18 |
| E0764 | Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program | 11 | $12,369.80 |
| E0765 | Fda approved nerve stimulator, for treatment of nausea and vomiting | 10 | $94.03 |
| E0766 | Electrical stimulation device used for cancer treatment, includes all accessories, any type | 23 | $13,517.40 |
| E0776 | Iv pole | 41 | $115.05 |
| E0779 | Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater | 32 | $163.34 |
| E0780 | Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours | 34 | $11.71 |
| E0781 | Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient | 42 | $2,138.83 |
| E0782 | Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) | 17 | $4,528.19 |
| E0783 | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | 19 | $8,436.05 |
| E0784 | External ambulatory infusion pump, insulin | 42 | $4,421.05 |
| E0785 | Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement | 13 | $548.21 |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | 17 | $9,118.50 |
| E0791 | Parenteral infusion pump, stationary, single or multi-channel | 38 | $2,254.24 |
| E0840 | Traction frame, attached to headboard, cervical traction | 37 | $67.65 |
| E0849 | Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible | 28 | $546.19 |
| E0850 | Traction stand, free standing, cervical traction | 36 | $89.41 |
| E0855 | Cervical traction equipment not requiring additional stand or frame | 27 | $552.48 |
| E0856 | Cervical traction device, with inflatable air bladder(s) | 18 | $172.00 |
| E0860 | Traction equipment, overdoor, cervical | 39 | $42.22 |
| E0870 | Traction frame, attached to footboard, extremity traction, (e.g., buck's) | 37 | $125.51 |
| E0880 | Traction stand, free standing, extremity traction | 36 | $138.79 |
| E0890 | Traction frame, attached to footboard, pelvic traction | 39 | $128.99 |
| E0900 | Traction stand, free standing, pelvic traction, (e.g., buck's) | 38 | $134.31 |
| E0910 | Trapeze bars, a/k/a patient helper, attached to bed, with grab bar | 45 | $141.30 |
| E0911 | Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar | 39 | $430.11 |
| E0912 | Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar | 39 | $827.19 |
| E0920 | Fracture frame, attached to bed, includes weights | 38 | $376.51 |
| E0930 | Fracture frame, free standing, includes weights | 37 | $371.50 |
| E0935 | Continuous passive motion exercise device for use on knee only | 36 | $24.10 |
| E0940 | Trapeze bar, free standing, complete with grab bar | 44 | $260.20 |
| E0941 | Gravity assisted traction device, any type | 29 | $363.00 |
| E0942 | Cervical head harness/halter | 41 | $20.14 |
| E0944 | Pelvic belt/harness/boot | 38 | $41.31 |
| E0945 | Extremity belt/harness | 33 | $44.21 |
| E0946 | Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster) | 32 | $519.56 |
| E0947 | Fracture frame, attachments for complex pelvic traction | 36 | $642.92 |
| E0948 | Fracture frame, attachments for complex cervical traction | 34 | $615.33 |
| E0950 | Wheelchair accessory, tray, each | 43 | $89.58 |
| E0951 | Heel loop/holder, any type, with or without ankle strap, each | 45 | $17.33 |
| E0952 | Toe loop/holder, any type, each | 43 | $16.59 |
| E0953 | Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each | 44 | $85.45 |
| E0954 | Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot | 42 | $57.65 |
| E0955 | Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each | 42 | $175.53 |
| E0956 | Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each | 43 | $89.26 |
| E0957 | Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each | 42 | $129.23 |
| E0958 | Manual wheelchair accessory, one-arm drive attachment, each | 43 | $417.40 |
| E0959 | Manual wheelchair accessory, adapter for amputee, each | 44 | $48.82 |
| E0960 | Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware | 43 | $83.71 |
| E0961 | Manual wheelchair accessory, wheel lock brake extension (handle), each | 44 | $24.02 |
| E0966 | Manual wheelchair accessory, headrest extension, each | 43 | $69.17 |
| E0967 | Manual wheelchair accessory, hand rim with projections, any type, replacement only, each | 44 | $73.80 |
| E0968 | Commode seat, wheelchair | 31 | $153.92 |
| E0969 | Narrowing device, wheelchair | 36 | $162.53 |
| E0970 | No. 2 footplates, except for elevating leg rest | 24 | $40.85 |
| E0971 | Manual wheelchair accessory, anti-tipping device, each | 44 | $42.50 |
| E0973 | Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each | 45 | $80.01 |
| E0974 | Manual wheelchair accessory, anti-rollback device, each | 43 | $74.71 |
| E0978 | Wheelchair accessory, positioning belt/safety belt/pelvic strap, each | 44 | $32.14 |
| E0980 | Safety vest, wheelchair | 38 | $36.85 |
| E0981 | Wheelchair accessory, seat upholstery, replacement only, each | 41 | $41.74 |
| E0982 | Wheelchair accessory, back upholstery, replacement only, each | 40 | $45.47 |
| E0983 | Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control | 33 | $2,387.80 |
| E0984 | Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control | 32 | $1,719.52 |
| E0985 | Wheelchair accessory, seat lift mechanism | 26 | $202.64 |
| E0986 | Manual wheelchair accessory, power assist system | 37 | $5,638.40 |
| E0988 | Manual wheelchair accessory, lever-activated, wheel drive, pair | 20 | $2,623.65 |
| E0990 | Wheelchair accessory, elevating leg rest, complete assembly, each | 42 | $94.64 |
| E0992 | Manual wheelchair accessory, solid seat insert | 44 | $89.39 |
| E0994 | Arm rest, each | 38 | $17.60 |
| E0995 | Wheelchair accessory, calf rest/pad, replacement only, each | 42 | $26.35 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.