Top 20 durable medical equipment procedure codes

There are over 500 Healthcare Common Procedure Coding System (HCPCS) codes for Durable Medical Equipment (DME) for patients’ every day use.

What is durable medical equipment (DME)?

DME describes medical equipment and supplies ordered by a healthcare provider for a patient’s routine, long-term use. The coverage for DME may include oxygen systems and accessories, canes, wheelchairs, crutches, infusion pumps, and glucose monitors. As the incidence of chronic diseases increases, there will be a growing need for devices to support patients.

Based on data from the Definitive Healthcare ClaimsMx product, we reviewed the DME codes for 2021. The following are the top DME procedure codes with the highest number of claims.

DME procedure codes with most claims in 2021

Rank HCPCS code HCPCS description Total procedures 2021
1 E0601 Continuous positive airway pressure (CPAP) device 232,241
2 E0114 Crutches underarm, other than wood, adjustable or fixed pair, with pads, tips and handgrips 112,128
3 E0562 Humidifier, heated, used with positive airway pressure (PAP) device 59,553
4 E1390 Oxygen concentrator 28,333
5 E1399 Durable medical equipment, miscellaneous 24,381
6 E0604 Hospital grade electric breast pump 19,009
7 E0776 IV pole 18,530
8 E0470 Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface 17,684
9 E0570 Nebulizer with compression 17,155
10 E0730 Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation 16,872
11 E0143 Walker folding wheeled 14,823
12 E0486 Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment 14,043
13 E0431 Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing 13,653
14 E0791 Parenteral infusion pump, stationary, single or multi-channel 13,610
15 E0700 Safety equipment 12,680
16 E0100 Cane adjust/fixed with tip 11,673
17 E0600 Respiratory suction pump, home model, portable or stationary, electric 10,565
18 E0780 Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours 8,376
19 E0190 Positioning cushion/pillow/wedge 7,109
20 E0781 Ambulatory infusion pump 6,812

Fig. 1 Data from the Definitive Healthcare ClaimsMx product for calendar year 2021. Claims data is sourced from multiple medical claims clearinghouses in the United States and updated monthly. Data accurate as of August 2022.

Which DME procedure codes have the highest number of claims?

Codes for continuous positive airway pressure (CPAP) devices (E0601) top the DME list with 232,000 claims. Crutches (E0114), and humidifiers (E0562) complete the top three.

Eight of the top 20 DME codes are related to respiratory needs including oxygen concentrators (E1390), nebulizers (E0570), and portable oxygen systems (E0431). The COVID-19 pandemic most likely contributed to the high number of claims for respiratory DME codes.

What types of DME does insurance cover?

While levels of insurance coverage vary based on payors, including Medicare and Medicaid coverage of DME, the main types of DME are:

  • Oxygen devices and accessories
  • Humidifier equipment
  • Walking aids      
  • Hospital beds and related supplies
  • Wheelchairs and mobility devices
  • Orthotics
  • Infusion supplies
  • Breast pumps

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