| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
135,171 |
126,951 |
$6.84M |
| E0601 |
Continuous positive airway pressure (cpap) device |
43,946 |
40,965 |
$1.01M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
108,141 |
101,785 |
$1.01M |
| A7030 |
Full face mask used with positive airway pressure device, each |
17,034 |
16,330 |
$882K |
| E0570 |
Nebulizer, with compressor |
19,008 |
17,964 |
$659K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
4,428 |
3,800 |
$572K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,333 |
1,258 |
$472K |
| K0001 |
Standard wheelchair |
36,419 |
32,813 |
$420K |
| A7031 |
Face mask interface, replacement for full face mask, each |
18,626 |
17,450 |
$415K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,732 |
1,618 |
$389K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,985 |
5,654 |
$388K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
6,388 |
6,155 |
$350K |
| 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) |
7,051 |
6,618 |
$340K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
16,718 |
14,631 |
$330K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
1,006 |
986 |
$328K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
700 |
656 |
$298K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
8,023 |
7,642 |
$263K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,627 |
3,483 |
$253K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,596 |
3,402 |
$243K |
| 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) |
1,906 |
1,758 |
$226K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
7,380 |
7,094 |
$220K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
8,380 |
7,941 |
$218K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
2,299 |
2,033 |
$181K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,935 |
3,791 |
$169K |
| A7035 |
Headgear used with positive airway pressure device |
15,940 |
15,191 |
$169K |
| A7037 |
Tubing used with positive airway pressure device |
21,757 |
20,585 |
$164K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
9,139 |
7,662 |
$164K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,738 |
2,619 |
$160K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
2,692 |
2,338 |
$141K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
2,701 |
2,230 |
$135K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
49,561 |
44,351 |
$125K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
5,075 |
4,467 |
$103K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
4,822 |
4,663 |
$97K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
2,912 |
2,442 |
$96K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,562 |
4,382 |
$96K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
4,004 |
3,876 |
$94K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12,803 |
11,698 |
$90K |
| A4649 |
Surgical supply; miscellaneous |
3,314 |
2,500 |
$89K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,093 |
1,041 |
$86K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
4,224 |
3,994 |
$85K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
5,063 |
3,957 |
$81K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,264 |
1,819 |
$80K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,553 |
2,143 |
$79K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,634 |
877 |
$77K |
| E0277 |
Powered pressure-reducing air mattress |
1,073 |
869 |
$74K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
4,799 |
4,058 |
$74K |
| K0007 |
Extra heavy duty wheelchair |
1,869 |
1,685 |
$73K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
9,704 |
9,255 |
$71K |
| K0003 |
Lightweight wheelchair |
3,596 |
3,278 |
$70K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
440 |
428 |
$68K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,273 |
1,132 |
$66K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
705 |
645 |
$64K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
815 |
809 |
$63K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,820 |
1,590 |
$54K |
| E0245 |
Tub stool or bench |
912 |
861 |
$53K |
| A4670 |
Automatic blood pressure monitor |
1,982 |
1,960 |
$51K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
4,729 |
3,611 |
$51K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,117 |
1,025 |
$49K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
562 |
489 |
$47K |
| E1399 |
Durable medical equipment, miscellaneous |
356 |
300 |
$46K |
| E1392 |
Portable oxygen concentrator, rental |
4,618 |
4,373 |
$46K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
693 |
633 |
$44K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
1,464 |
1,441 |
$44K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
658 |
626 |
$41K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
5,786 |
4,609 |
$38K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
143 |
102 |
$38K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
902 |
790 |
$35K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
557 |
490 |
$35K |
| A4623 |
Tracheostomy, inner cannula |
538 |
466 |
$35K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
1,259 |
1,031 |
$33K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
5,146 |
4,907 |
$29K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
8,491 |
8,014 |
$28K |
| E0156 |
Seat attachment, walker |
3,620 |
3,402 |
$27K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
424 |
361 |
$27K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
127 |
113 |
$26K |
| 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 |
466 |
446 |
$25K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
1,069 |
959 |
$24K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
333 |
301 |
$21K |
| A5120 |
Skin barrier, wipes or swabs, each |
3,930 |
3,321 |
$21K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
3,001 |
2,503 |
$21K |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
253 |
250 |
$21K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
393 |
379 |
$20K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
5,474 |
5,313 |
$19K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
2,546 |
1,941 |
$18K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
638 |
587 |
$17K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
2,822 |
2,446 |
$17K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
5,690 |
5,237 |
$17K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
122 |
105 |
$17K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
402 |
359 |
$16K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
646 |
600 |
$15K |
| E0635 |
Patient lift, electric with seat or sling |
442 |
409 |
$13K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
3,222 |
2,488 |
$12K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
413 |
368 |
$12K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,575 |
2,206 |
$11K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
1,062 |
918 |
$11K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,798 |
2,442 |
$11K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,580 |
1,221 |
$11K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
462 |
433 |
$11K |
| A7000 |
Canister, disposable, used with suction pump, each |
2,607 |
2,335 |
$10K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
612 |
553 |
$10K |
| A7002 |
Tubing, used with suction pump, each |
3,447 |
2,710 |
$10K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
377 |
361 |
$9K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
111 |
106 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
817 |
636 |
$9K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,137 |
922 |
$9K |
| A4402 |
Lubricant, per ounce |
1,404 |
1,211 |
$7K |
| E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
748 |
734 |
$7K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
1,272 |
1,154 |
$7K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
94 |
89 |
$7K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
184 |
176 |
$7K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
1,379 |
1,101 |
$6K |
| A4217 |
Sterile water/saline, 500 ml |
114 |
104 |
$6K |
| K0006 |
Heavy duty wheelchair |
138 |
122 |
$6K |
| A7507 |
Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each |
527 |
422 |
$5K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,842 |
1,394 |
$4K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
252 |
238 |
$4K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,737 |
1,604 |
$4K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,395 |
2,302 |
$4K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,278 |
1,103 |
$3K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
27 |
26 |
$3K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
256 |
236 |
$3K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
15 |
12 |
$3K |
| E0621 |
Sling or seat, patient lift, canvas or nylon |
145 |
126 |
$3K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
321 |
314 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,661 |
1,595 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
60 |
40 |
$2K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
29 |
24 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,462 |
1,368 |
$2K |
| A4371 |
Ostomy skin barrier, powder, per oz |
731 |
678 |
$2K |
| A4367 |
Ostomy belt, each |
482 |
449 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,674 |
2,557 |
$2K |
| A7525 |
Tracheostomy mask, each |
1,207 |
1,048 |
$2K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
161 |
155 |
$2K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,713 |
1,104 |
$1K |
| A7012 |
Water collection device, used with large volume nebulizer |
540 |
466 |
$1K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
57 |
56 |
$1K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
12 |
12 |
$791.50 |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
56 |
48 |
$788.73 |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
96 |
62 |
$720.69 |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
14 |
13 |
$691.20 |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
1,208 |
1,008 |
$626.98 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
427 |
368 |
$581.62 |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
30 |
24 |
$515.58 |
| E0244 |
Raised toilet seat |
14 |
12 |
$477.13 |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
188 |
104 |
$467.01 |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
961 |
773 |
$395.67 |
| A4322 |
Irrigation syringe, bulb or piston, each |
30 |
27 |
$373.95 |
| A4618 |
Breathing circuits |
27 |
24 |
$283.19 |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
47 |
39 |
$241.26 |
| E0241 |
Bath tub wall rail, each |
15 |
15 |
$240.10 |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
72 |
61 |
$215.05 |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
132 |
117 |
$212.24 |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
182 |
121 |
$174.01 |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
423 |
389 |
$162.61 |
| A7036 |
Chinstrap used with positive airway pressure device |
18 |
17 |
$109.68 |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
12 |
12 |
$107.43 |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
40 |
24 |
$93.48 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
84 |
80 |
$47.32 |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
17 |
16 |
$36.35 |
| A4332 |
Lubricant, individual sterile packet, each |
15 |
13 |
$16.07 |
| A4456 |
Adhesive remover, wipes, any type, each |
21 |
14 |
$0.11 |
| B4104 |
Additive for enteral formula (e.g., fiber) |
1,137 |
1,013 |
$0.00 |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
44 |
40 |
$0.00 |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
12 |
12 |
$0.00 |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
77 |
65 |
$0.00 |