E0657 — Segmental pneumatic appliance for use with pneumatic compressor, chest
HCPCS Level II E-code · short descriptor: “Segmental pneumatic chest”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Capped rental
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
E0657 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $77.37 to $92.81 depending on state and rural status.
Former-CBA payment limits: ceiling $77.37 · floor $65.76
| State | Non-rural | Rural |
|---|---|---|
| AK | $77.37 | — |
| AL | $77.37 | — |
| AR | $77.37 | — |
| AZ | $77.37 | — |
| CA | $77.37 | — |
| CO | $77.37 | — |
| CT | $77.37 | — |
| DC | $77.37 | — |
| DE | $77.37 | — |
| FL | $77.37 | — |
| GA | $77.37 | — |
| HI | $77.37 | — |
| IA | $77.37 | — |
| ID | $77.37 | — |
| IL | $77.37 | — |
| IN | $77.37 | — |
| KS | $77.37 | — |
| KY | $77.37 | — |
| LA | $77.37 | — |
| MA | $77.37 | — |
| MD | $77.37 | — |
| ME | $77.37 | — |
| MI | $77.37 | — |
| MN | $77.37 | — |
| MO | $77.37 | — |
| MS | $77.37 | — |
| MT | $77.37 | — |
| NC | $77.37 | — |
| ND | $77.37 | — |
| NE | $77.37 | — |
| NH | $77.37 | — |
| NJ | $77.37 | — |
| NM | $77.37 | — |
| NV | $77.37 | — |
| NY | $77.37 | — |
| OH | $77.37 | — |
| OK | $77.37 | — |
| OR | $77.37 | — |
| PA | $77.37 | — |
| PR | $92.81 | — |
| RI | $77.37 | — |
| SC | $77.37 | — |
| SD | $77.37 | — |
| TN | $77.37 | — |
| TX | $77.37 | — |
| UT | $77.37 | — |
| VA | $77.37 | — |
| VI | $77.37 | — |
| VT | $77.37 | — |
| WA | $77.37 | — |
| WI | $77.37 | — |
| WV | $77.37 | — |
| WY | $77.37 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related E-codes
Bill E0657 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →