Healthcare Insights

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

Explore dataset

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

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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