| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
58,227 |
35,277 |
$41.27M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
528,215 |
497,756 |
$36.81M |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
58,619 |
54,789 |
$24.43M |
| A4605 |
Tracheal suction catheter, closed system, each |
13,664 |
12,841 |
$6.26M |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
32,597 |
29,661 |
$6.00M |
| 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 |
8,148 |
7,832 |
$5.16M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
28,334 |
27,822 |
$5.06M |
| E0601 |
Continuous positive airway pressure (cpap) device |
120,015 |
115,526 |
$5.02M |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
319,681 |
301,652 |
$4.61M |
| A7526 |
Tracheostomy tube collar/holder, each |
40,698 |
39,199 |
$3.64M |
| 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) |
8,890 |
8,210 |
$3.13M |
| E0482 |
Cough stimulating device, alternating positive and negative airway pressure |
8,023 |
7,831 |
$2.95M |
| E0481 |
Intrapulmonary percussive ventilation system and related accessories |
3,096 |
3,044 |
$2.68M |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
30,783 |
28,776 |
$2.35M |
| E1392 |
Portable oxygen concentrator, rental |
110,572 |
105,246 |
$2.21M |
| A4606 |
Oxygen probe for use with oximeter device, replacement |
22,685 |
21,825 |
$2.21M |
| 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) |
20,905 |
20,118 |
$2.17M |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
45,441 |
42,333 |
$2.16M |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
73,367 |
70,513 |
$2.02M |
| K0001 |
Standard wheelchair |
69,250 |
65,844 |
$1.91M |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
40,182 |
36,512 |
$1.79M |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
7,277 |
6,593 |
$1.79M |
| A4623 |
Tracheostomy, inner cannula |
10,624 |
9,957 |
$1.61M |
| E0570 |
Nebulizer, with compressor |
66,376 |
62,835 |
$1.60M |
| T4541 |
Incontinence product, disposable underpad, large, each |
40,919 |
39,550 |
$1.50M |
| A4629 |
Tracheostomy care kit for established tracheostomy |
22,369 |
21,335 |
$1.23M |
| A7000 |
Canister, disposable, used with suction pump, each |
55,425 |
51,643 |
$1.23M |
| A7030 |
Full face mask used with positive airway pressure device, each |
21,940 |
21,233 |
$1.20M |
| S8189 |
Tracheostomy supply, not otherwise classified |
2,763 |
2,585 |
$1.19M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
8,924 |
8,163 |
$1.13M |
| E0277 |
Powered pressure-reducing air mattress |
3,600 |
3,262 |
$1.06M |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
23,000 |
22,282 |
$1.05M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
13,551 |
13,201 |
$1.02M |
| B9998 |
Noc for enteral supplies |
11,438 |
10,277 |
$831K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
19,547 |
18,747 |
$808K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
11,531 |
11,220 |
$759K |
| A7002 |
Tubing, used with suction pump, each |
58,175 |
50,028 |
$708K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
41,880 |
39,039 |
$707K |
| A4322 |
Irrigation syringe, bulb or piston, each |
10,903 |
10,308 |
$695K |
| A7509 |
Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each |
8,820 |
8,250 |
$693K |
| E1235 |
Wheelchair, pediatric size, rigid, adjustable, with seating system |
4,723 |
4,532 |
$678K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
3,295 |
3,043 |
$677K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
5,236 |
5,024 |
$627K |
| A7035 |
Headgear used with positive airway pressure device |
39,436 |
38,209 |
$579K |
| E1399 |
Durable medical equipment, miscellaneous |
3,551 |
3,325 |
$575K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
6,255 |
5,896 |
$571K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
7,822 |
7,592 |
$570K |
| L8501 |
Tracheostomy speaking valve |
7,130 |
6,967 |
$569K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
18,478 |
17,631 |
$553K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
43,298 |
40,916 |
$533K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
6,920 |
6,218 |
$511K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
10,533 |
9,632 |
$485K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
14,696 |
13,599 |
$463K |
| K0007 |
Extra heavy duty wheelchair |
5,067 |
4,792 |
$458K |
| K0003 |
Lightweight wheelchair |
13,002 |
12,211 |
$450K |
| A7037 |
Tubing used with positive airway pressure device |
30,785 |
29,848 |
$442K |
| B9002 |
Enteral nutrition infusion pump, any type |
5,374 |
5,257 |
$435K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
31,505 |
28,502 |
$412K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
10,668 |
10,142 |
$412K |
| A7031 |
Face mask interface, replacement for full face mask, each |
11,955 |
11,442 |
$395K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
50,518 |
48,227 |
$388K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
13,446 |
12,952 |
$368K |
| 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 |
3,549 |
2,902 |
$356K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
893 |
796 |
$331K |
| 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 |
19,125 |
18,221 |
$330K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
6,387 |
6,113 |
$310K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
7,436 |
6,957 |
$289K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
9,534 |
9,144 |
$285K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
6,962 |
6,719 |
$275K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,457 |
5,169 |
$239K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
6,789 |
6,531 |
$239K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,782 |
2,654 |
$237K |
| 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 |
806 |
699 |
$235K |
| E0245 |
Tub stool or bench |
5,296 |
5,118 |
$226K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,971 |
1,909 |
$225K |
| A4927 |
Gloves, non-sterile, per 100 |
22,468 |
21,794 |
$196K |
| 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 |
8,611 |
5,607 |
$178K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
16,578 |
16,102 |
$160K |
| S9340 |
Home therapy; enteral nutrition; administrative services, professional pharmacy services, care coordination, and all necessary supplies and equipment (enteral formula and nursing visits coded separately), per diem |
429 |
415 |
$152K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
869 |
831 |
$136K |
| E0619 |
Apnea monitor, with recording feature |
845 |
820 |
$136K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,274 |
3,091 |
$136K |
| K0006 |
Heavy duty wheelchair |
2,373 |
2,299 |
$132K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
22,562 |
21,985 |
$131K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
4,942 |
4,609 |
$129K |
| 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 |
537 |
510 |
$124K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
1,748 |
1,728 |
$119K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,984 |
1,888 |
$116K |
| A7525 |
Tracheostomy mask, each |
16,317 |
15,822 |
$114K |
| 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 |
873 |
742 |
$113K |
| J7606 |
Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms |
591 |
583 |
$102K |
| 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 |
472 |
411 |
$99K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
7,376 |
7,133 |
$92K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
2,229 |
2,165 |
$88K |
| J7677 |
Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram |
439 |
434 |
$88K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,703 |
1,637 |
$86K |
| E0271 |
Mattress, innerspring |
6,458 |
5,765 |
$84K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,252 |
1,236 |
$77K |
| E0776 |
Iv pole |
5,380 |
5,030 |
$74K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
4,305 |
4,160 |
$74K |
| A4217 |
Sterile water/saline, 500 ml |
4,210 |
3,951 |
$69K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
796 |
762 |
$65K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
12,209 |
11,168 |
$64K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,907 |
1,838 |
$63K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
1,008 |
764 |
$61K |
| E0305 |
Bed side rails, half length |
5,498 |
4,882 |
$60K |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
862 |
848 |
$57K |
| E0156 |
Seat attachment, walker |
6,370 |
6,147 |
$56K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
27,072 |
26,007 |
$55K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
11,503 |
10,916 |
$52K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
4,993 |
4,669 |
$47K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
16,367 |
14,834 |
$43K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
682 |
653 |
$43K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
495 |
462 |
$40K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,176 |
1,982 |
$37K |
| A7012 |
Water collection device, used with large volume nebulizer |
7,375 |
6,948 |
$37K |
| A4554 |
Disposable underpads, all sizes |
797 |
775 |
$35K |
| 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 |
298 |
280 |
$34K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
1,984 |
1,869 |
$28K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
887 |
832 |
$25K |
| E0966 |
Manual wheelchair accessory, headrest extension, each |
4,017 |
3,883 |
$23K |
| A7527 |
Tracheostomy/laryngectomy tube plug/stop, each |
3,014 |
2,950 |
$23K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
1,479 |
1,447 |
$22K |
| A4402 |
Lubricant, per ounce |
8,915 |
8,735 |
$21K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
872 |
837 |
$20K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,248 |
1,184 |
$19K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
219 |
204 |
$18K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,124 |
1,055 |
$15K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
1,238 |
1,202 |
$15K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
2,056 |
2,024 |
$14K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
243 |
231 |
$13K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,721 |
1,664 |
$13K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,483 |
1,422 |
$13K |
| E0310 |
Bed side rails, full length |
946 |
890 |
$13K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,341 |
1,281 |
$13K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
332 |
297 |
$13K |
| A7036 |
Chinstrap used with positive airway pressure device |
1,525 |
1,487 |
$13K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
646 |
608 |
$12K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,519 |
1,424 |
$12K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,125 |
1,116 |
$11K |
| A7015 |
Aerosol mask, used with dme nebulizer |
6,726 |
6,480 |
$10K |
| A4649 |
Surgical supply; miscellaneous |
721 |
679 |
$9K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
131 |
127 |
$9K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
173 |
161 |
$8K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
136 |
132 |
$7K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
118 |
115 |
$7K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
40 |
39 |
$7K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
421 |
417 |
$6K |
| K0045 |
Footrest, complete assembly, replacement only, each |
1,097 |
1,080 |
$6K |
| Q0514 |
Pharmacy dispensing fee for inhalation drug(s); per 90 days |
719 |
718 |
$6K |
| G0333 |
Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary |
600 |
593 |
$6K |
| E0935 |
Continuous passive motion exercise device for use on knee only |
27 |
26 |
$5K |
| A9270 |
Non-covered item or service |
454 |
426 |
$5K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
332 |
312 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
11,870 |
8,347 |
$3K |
| A4625 |
Tracheostomy care kit for new tracheostomy |
62 |
61 |
$3K |
| J7699 |
Noc drugs, inhalation solution administered through dme |
14 |
13 |
$3K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
2,157 |
2,083 |
$2K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
180 |
177 |
$2K |
| A4332 |
Lubricant, individual sterile packet, each |
2,173 |
2,135 |
$2K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
159 |
152 |
$2K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
405 |
370 |
$2K |
| A4657 |
Syringe, with or without needle, each |
638 |
617 |
$2K |
| E1014 |
Reclining back, addition to pediatric size wheelchair |
65 |
62 |
$1K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
159 |
151 |
$953.06 |
| J7605 |
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms |
27 |
26 |
$919.64 |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
27 |
25 |
$890.74 |
| E0244 |
Raised toilet seat |
29 |
25 |
$791.33 |
| E0621 |
Sling or seat, patient lift, canvas or nylon |
16 |
14 |
$590.77 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
67 |
67 |
$547.03 |
| A4452 |
Tape, waterproof, per 18 square inches |
69 |
64 |
$477.90 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
597 |
562 |
$375.78 |
| A4616 |
Tubing (oxygen), per foot |
79 |
74 |
$325.31 |
| A4670 |
Automatic blood pressure monitor |
80 |
72 |
$325.30 |
| A4371 |
Ostomy skin barrier, powder, per oz |
113 |
109 |
$276.01 |
| A7020 |
Interface for cough stimulating device, includes all components, replacement only |
13 |
13 |
$225.76 |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
12 |
12 |
$212.90 |
| E0241 |
Bath tub wall rail, each |
18 |
13 |
$121.58 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
12 |
$0.00 |