| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
11,722 |
11,222 |
$777K |
| E1392 |
Portable oxygen concentrator, rental |
3,486 |
3,335 |
$757K |
| E0277 |
Powered pressure-reducing air mattress |
3,865 |
3,483 |
$580K |
| E1399 |
Durable medical equipment, miscellaneous |
3,678 |
2,515 |
$504K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
6,227 |
5,973 |
$492K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
16,871 |
16,441 |
$434K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
2,525 |
2,338 |
$359K |
| E0601 |
Continuous positive airway pressure (cpap) device |
4,056 |
3,788 |
$239K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
3,363 |
3,277 |
$224K |
| 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 |
1,580 |
1,512 |
$212K |
| 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) |
1,082 |
1,030 |
$158K |
| K0001 |
Standard wheelchair |
5,170 |
4,944 |
$132K |
| E0635 |
Patient lift, electric with seat or sling |
799 |
774 |
$107K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
1,942 |
1,800 |
$74K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
2,389 |
2,215 |
$63K |
| E0570 |
Nebulizer, with compressor |
5,087 |
4,839 |
$63K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,654 |
1,521 |
$62K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
400 |
393 |
$47K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
2,197 |
2,096 |
$47K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,703 |
1,608 |
$39K |
| E0627 |
Seat lift mechanism, electric, any type |
831 |
819 |
$37K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
600 |
589 |
$36K |
| E0621 |
Sling or seat, patient lift, canvas or nylon |
754 |
707 |
$35K |
| E0274 |
Over-bed table |
1,362 |
1,352 |
$31K |
| E0184 |
Dry pressure mattress |
580 |
549 |
$29K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
430 |
419 |
$27K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
436 |
411 |
$23K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
751 |
729 |
$21K |
| E0430 |
Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing |
596 |
569 |
$13K |
| E1060 |
Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests |
553 |
525 |
$13K |
| K0006 |
Heavy duty wheelchair |
349 |
343 |
$12K |
| S5162 |
Emergency response system; purchase only |
281 |
273 |
$11K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
692 |
674 |
$10K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
1,022 |
978 |
$10K |
| E0315 |
Bed accessory: board, table, or support device, any type |
106 |
104 |
$10K |
| E0140 |
Walker, with trunk support, adjustable or fixed height, any type |
627 |
564 |
$9K |
| E0272 |
Mattress, foam rubber |
498 |
480 |
$7K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
203 |
202 |
$6K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
32 |
32 |
$5K |
| E0271 |
Mattress, innerspring |
349 |
343 |
$5K |
| A9270 |
Non-covered item or service |
272 |
244 |
$5K |
| E0305 |
Bed side rails, half length |
304 |
289 |
$4K |
| E1391 |
Oxygen concentrator, dual delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate, each |
25 |
25 |
$4K |
| E1354 |
Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each |
341 |
328 |
$4K |
| E1353 |
Regulator |
296 |
254 |
$4K |
| 98960 |
|
23 |
20 |
$4K |
| E0241 |
Bath tub wall rail, each |
15 |
13 |
$4K |
| 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) |
13 |
13 |
$4K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
16 |
16 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
40 |
37 |
$3K |
| A9280 |
Alert or alarm device, not otherwise classified |
134 |
124 |
$3K |
| E0940 |
Trapeze bar, free standing, complete with grab bar |
160 |
159 |
$2K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
35 |
31 |
$2K |
| E2604 |
Skin protection wheelchair seat cushion, width 22 inches or greater, any depth |
178 |
172 |
$2K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
26 |
25 |
$1K |
| A7030 |
Full face mask used with positive airway pressure device, each |
14 |
14 |
$1K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
27 |
20 |
$949.50 |
| E0434 |
Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing |
27 |
27 |
$750.00 |
| K0045 |
Footrest, complete assembly, replacement only, each |
57 |
57 |
$719.30 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
31 |
24 |
$627.50 |
| A4615 |
Cannula, nasal |
90 |
59 |
$622.50 |
| E0141 |
Walker, rigid, wheeled, adjustable or fixed height |
40 |
40 |
$600.00 |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
15 |
12 |
$419.77 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
33 |
28 |
$265.02 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
15 |
14 |
$187.10 |
| A4616 |
Tubing (oxygen), per foot |
17 |
16 |
$78.00 |