HCPCS Codes for Lump sum purchase of DME, prosthetics, orthotics


  • A7525

    Tracheostomy mask, each
  • A7526

    Tracheostomy tube collar/holder, each
  • A7527

    Tracheostomy/laryngectomy tube plug/stop, each
  • A9283

    Foot pressure off loading/supportive device, any type, each
  • E0232

    Warming card for use with the non contact wound warming device and non contact wound warming wound cover
  • E0441

    Stationary oxygen contents, gaseous, 1 month's supply = 1 unit
  • E0442

    Stationary oxygen contents, liquid, 1 month's supply = 1 unit
  • E0443

    Portable oxygen contents, gaseous, 1 month's supply = 1 unit
  • E0444

    Portable oxygen contents, liquid, 1 month's supply = 1 unit
  • E0447

    Portable oxygen contents, liquid, 1 month's supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)
  • E0485

    Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment
  • E0486

    Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
  • E0491

    Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply
  • E0555

    Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter
  • E0580

    Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter
  • E0785

    Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement
  • E0830

    Ambulatory traction device, all types, each
  • E1220

    Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
  • E1352

    Oxygen accessory, flow regulator capable of positive inspiratory pressure
  • E1701

    Replacement cushions for jaw motion rehabilitation system, pkg. of 6
  • E1702

    Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200
  • E1800

    Dynamic adjustable elbow extension and flexion device, includes soft interface material
  • E1801

    Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
  • E1803

    Dynamic adjustable elbow extension only device, includes soft interface material
  • E1804

    Dynamic adjustable elbow flexion only device, includes soft interface material
  • E1805

    Dynamic adjustable wrist extension and flexion device, includes soft interface material
  • E1806

    Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
  • E1807

    Dynamic adjustable wrist extension only device, includes soft interface material
  • E1808

    Dynamic adjustable wrist flexion only device, includes soft interface material
  • E1810

    Dynamic adjustable knee extension and flexion device, includes soft interface material
  • E1811

    Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
  • E1812

    Dynamic knee, extension/flexion device with active resistance control
  • E1813

    Dynamic adjustable knee extension only device, includes soft interface material
  • E1814

    Dynamic adjustable knee flexion only device, includes soft interface material
  • E1815

    Dynamic adjustable ankle extension and flexion device, includes soft interface material
  • E1816

    Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
  • E1818

    Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories
  • E1820

    Replacement soft interface material, dynamic adjustable extension/flexion device
  • E1821

    Replacement soft interface material/cuffs for bi-directional static progressive stretch device
  • E1822

    Dynamic adjustable ankle extension only device, includes soft interface material
  • E1823

    Dynamic adjustable ankle flexion only device, includes soft interface material
  • E1825

    Dynamic adjustable finger extension and flexion device, includes soft interface material
  • E1826

    Dynamic adjustable finger extension only device, includes soft interface material
  • E1827

    Dynamic adjustable finger flexion only device, includes soft interface material
  • E1828

    Dynamic adjustable toe extension only device, includes soft interface material
  • E1829

    Dynamic adjustable toe flexion only device, includes soft interface material
  • E1830

    Dynamic adjustable toe extension and flexion device, includes soft interface material
  • E1831

    Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
  • E1840

    Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material
  • E2397

    Power wheelchair accessory, lithium-based battery, each