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Healthcare Insights

Top durable medical equipment procedure codes

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

What is durable medical equipment (DME)? 

Durable medical equipment refers to 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 instances of chronic disease increase, there is a growing need for devices to support patients in managing their conditions.  

What HCPCS codes are used for DME? 

HCPCS codes come from a code set developed by CMS for reporting medical procedures and services. These codes are grouped by a leading letter, and each letter represents a different group of healthcare-related supplies. Durable medical equipment is represented by the letter “E” code group. 

Using data from the Definitive Healthcare Atlas All-Payor Claims dataset, we have identified the top 20 most fulfilled durable medical equipment orders in 2022. This data represents the percentage of fulfilled DME orders in the U.S. and is based on physician ordering activity. 

Because the chart below was built using claims data, it only includes orders by physicians that were billed through insurance. Some patients may opt to buy some equipment without submitting through insurance.  

Top 20 fulfilled orders for durable medical equipment

RankHCPCS CodeHCPCS DescriptionPercent of fulfilled durable medical equipment orders in the U.S.Explore dataset
1E1390Oxygen concentrator24.17%Explore
2E0601Continuous positive airway pressure (CPAP) device 15.37%Explore
3E0431Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing 12.06%Explore
4E0562Humidifier, heated, used with positive airway pressure (PAP) device 7.35%Explore
5E0570Nebulizer with compression4.58%Explore
6E1392Portable oxygen concentrator4.38%Explore
7E0260Hospital bed, semi-electric, with mattress 2.26%Explore
8E0143Walker folding wheeled 2.18%Explore
9E0470Respiratory assist device, without backup rate feature 1.69%Explore
10E0466Home ventilator, with non-invasive interface 1.36%Explore
11E0114Crutches underarm, other than wood, adjustable or fixed pair, with pads, tips and handgrips 1.02%Explore
12E0603Electric breast pump0.94%Explore
13E1028Wheelchair accessory, manual swing away, retractable/removable mounting hardware for joystick 0.90%Explore
14E0971Manual wheelchair accessory, anti-tipping device 0.88%Explore
15E1399Durable medical equipment, miscellaneous 0.70%Explore
16E0156Walker seat attachment0.68%Explore
17E0163Commode chair with fixed arm0.67%Explore
18E0630Patient lift, hydraulic or mechanical 0.66%Explore
19E0973Wheelchair accessory, adjustable height, detachable armrest 0.58%Explore
20E0781Ambulatory infusion pump 0.57%Explore

Fig. 1 Data is from the Definitive Healthcare Atlas All-Payor Claims dataset and is updated yearly. Data accessed September 2023.

Which DME procedure codes have the highest volume of claims? 

The top DME procedure code by the percentage of fulfilled DME orders was for oxygen concentrators (E1390). Oxygen concentrators are medical devices that give the user extra oxygen. They are typically prescribed to patients with conditions that cause low levels of oxygen. This DME code accounts for nearly a quarter of all fulfilled DME orders. 

The second top DME code by the percentage of fulfilled orders was for continuous airway pressure devices (E0601), at 15.37%. Continuous airway pressure devices, more commonly called CPAP machines, are used to treat sleep apnea by delivering pressurized air through a mask that is worn during sleep. 

In third place was portable gaseous 02 (E0431), accounting for 12.06% of all fulfilled DME orders. Like oxygen concentrators, portable gaseous tanks provide supplemental oxygen to those with low oxygen levels. These portable devices allow people to receive oxygen while outside of the home. 

The following three DME codes – humidifiers (E0562), nebulizers with compression (E0570), and portable oxygen concentrators (E1392) – are also related to respiratory needs. The COVID-19 pandemic likely contributed to the high number of respiratory-related DME codes topping the list. 

What types of DME does insurance cover? 

Insurance coverage of durable medical equipment may vary based on payors, including Medicare/Medicaid DME coverage. Medicare requires that DME meet four criteria points: durability, utilized for medical needs, acceptable for in-home use, and generally not useful to someone uninjured or in good health. 

Despite varying coverage, generally, the main types of covered DME include: 

  • Oxygen devices and accessories 

  • Humidifier equipment 

  • Walking aids 

  • Hospital beds and related supplies 

  • Orthotics 

  • Infusion supplies 

  • Breast pumps 

Learn more 

Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians, and other healthcare providers.