| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
5,644 |
3,644 |
$9.59M |
| G0299 |
Direct skilled nursing services of a registered nurse (rn) in the home health or hospice setting, each 15 minutes |
47,006 |
8,721 |
$6.72M |
| G0159 |
Services performed by a qualified physical therapist, in the home health setting, in the establishment or delivery of a safe and effective physical therapy maintenance program, each 15 minutes |
36,989 |
7,497 |
$5.14M |
| S9123 |
Nursing care, in the home; by registered nurse, per hour (use for general nursing care only, not to be used when cpt codes 99500-99602 can be used) |
16,115 |
3,787 |
$2.40M |
| G0160 |
Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes |
14,122 |
3,326 |
$1.90M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
13,275 |
11,119 |
$1.72M |
| S9131 |
Physical therapy; in the home, per diem |
9,371 |
2,227 |
$1.45M |
| 99601 |
|
8,180 |
2,848 |
$1.04M |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
3,640 |
3,020 |
$1.04M |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
847 |
513 |
$933K |
| B9998 |
Noc for enteral supplies |
1,445 |
787 |
$932K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,923 |
1,464 |
$916K |
| A7030 |
Full face mask used with positive airway pressure device, each |
5,308 |
3,945 |
$583K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
475 |
343 |
$513K |
| S9129 |
Occupational therapy, in the home, per diem |
3,567 |
1,002 |
$511K |
| 99602 |
Nursing care in home rn |
2,565 |
1,119 |
$501K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,609 |
1,058 |
$477K |
| A7031 |
Face mask interface, replacement for full face mask, each |
9,987 |
7,185 |
$461K |
| 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 |
771 |
458 |
$381K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
3,915 |
2,932 |
$321K |
| 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 |
623 |
430 |
$300K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,325 |
806 |
$286K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
938 |
499 |
$281K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,382 |
1,120 |
$259K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
10,112 |
8,582 |
$246K |
| T4541 |
Incontinence product, disposable underpad, large, each |
4,416 |
3,180 |
$231K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
4,212 |
3,066 |
$213K |
| S9338 |
Home infusion therapy, immunotherapy, administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
1,792 |
929 |
$179K |
| 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 |
668 |
463 |
$176K |
| A7035 |
Headgear used with positive airway pressure device |
5,251 |
3,929 |
$168K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
3,608 |
2,611 |
$167K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,178 |
2,148 |
$160K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,536 |
1,117 |
$160K |
| E0570 |
Nebulizer, with compressor |
1,928 |
1,393 |
$152K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
17,712 |
12,622 |
$139K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,146 |
756 |
$138K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
553 |
396 |
$134K |
| A4927 |
Gloves, non-sterile, per 100 |
5,637 |
3,850 |
$128K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
826 |
602 |
$117K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
2,963 |
2,135 |
$107K |
| K0001 |
Standard wheelchair |
1,082 |
820 |
$105K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,504 |
1,002 |
$103K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,119 |
824 |
$102K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
1,470 |
1,105 |
$92K |
| 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 |
493 |
292 |
$83K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
45 |
37 |
$71K |
| A7037 |
Tubing used with positive airway pressure device |
3,179 |
2,386 |
$70K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
4,291 |
3,231 |
$66K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
248 |
184 |
$63K |
| A4413 |
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each |
76 |
37 |
$59K |
| A5120 |
Skin barrier, wipes or swabs, each |
2,123 |
1,226 |
$56K |
| E0572 |
Aerosol compressor, adjustable pressure, light duty for intermittent use |
214 |
179 |
$53K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
755 |
625 |
$46K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
343 |
257 |
$45K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,443 |
1,231 |
$42K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,481 |
1,075 |
$40K |
| A6210 |
Foam 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 |
64 |
39 |
$36K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,204 |
1,620 |
$33K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
157 |
97 |
$31K |
| 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 |
734 |
563 |
$30K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
95 |
89 |
$30K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,370 |
1,144 |
$30K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
40 |
38 |
$29K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,311 |
893 |
$26K |
| A4657 |
Syringe, with or without needle, each |
975 |
608 |
$25K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
218 |
147 |
$22K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
170 |
94 |
$18K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,812 |
1,327 |
$18K |
| A4245 |
Alcohol wipes, per box |
859 |
554 |
$17K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
153 |
114 |
$16K |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
389 |
111 |
$16K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,894 |
1,431 |
$16K |
| A6260 |
Wound cleansers, any type, any size |
652 |
505 |
$14K |
| S9330 |
Home infusion therapy, continuous (twenty-four hours or more) chemotherapy infusion; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem |
66 |
36 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
384 |
287 |
$12K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,878 |
1,107 |
$11K |
| A4217 |
Sterile water/saline, 500 ml |
533 |
465 |
$11K |
| 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 |
38 |
12 |
$10K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
257 |
193 |
$9K |
| E1399 |
Durable medical equipment, miscellaneous |
34 |
28 |
$9K |
| A4281 |
Tubing for breast pump, replacement |
134 |
68 |
$9K |
| E1392 |
Portable oxygen concentrator, rental |
241 |
188 |
$9K |
| S9342 |
Home therapy; enteral nutrition via pump; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
45 |
28 |
$7K |
| A4286 |
Locking ring for breast pump, replacement |
100 |
57 |
$7K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
15 |
15 |
$7K |
| A4283 |
Cap for breast pump bottle, replacement |
101 |
68 |
$7K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
34 |
12 |
$6K |
| A4284 |
Breast shield and splash protector for use with breast pump, replacement |
133 |
69 |
$6K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
53 |
13 |
$5K |
| A7526 |
Tracheostomy tube collar/holder, each |
40 |
24 |
$5K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
94 |
88 |
$4K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
74 |
63 |
$4K |
| A4371 |
Ostomy skin barrier, powder, per oz |
611 |
437 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
69 |
42 |
$4K |
| A4282 |
Adapter for breast pump, replacement |
70 |
43 |
$4K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
85 |
58 |
$4K |
| A4256 |
Normal, low and high calibrator solution / chips |
1,069 |
924 |
$3K |
| A4259 |
Lancets, per box of 100 |
1,364 |
1,175 |
$3K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
2,328 |
1,474 |
$3K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
42 |
24 |
$3K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
601 |
346 |
$3K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
17 |
13 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,326 |
1,115 |
$3K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
194 |
95 |
$3K |
| J9190 |
Injection, fluorouracil, 500 mg |
66 |
36 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
12 |
12 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
22 |
14 |
$2K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
725 |
447 |
$2K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
29 |
26 |
$2K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
62 |
49 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
27 |
26 |
$2K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
41 |
28 |
$2K |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
13 |
12 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
56 |
36 |
$871.34 |
| A4554 |
Disposable underpads, all sizes |
24 |
12 |
$689.04 |
| A7002 |
Tubing, used with suction pump, each |
65 |
37 |
$621.95 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
13 |
12 |
$615.68 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
24 |
12 |
$498.12 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
20 |
12 |
$401.12 |
| A7000 |
Canister, disposable, used with suction pump, each |
22 |
12 |
$351.58 |
| A4285 |
Polycarbonate bottle for use with breast pump, replacement |
60 |
43 |
$150.45 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
32 |
14 |
$148.93 |
| A7036 |
Chinstrap used with positive airway pressure device |
12 |
12 |
$140.69 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
23 |
13 |
$119.49 |