E0781 — Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient

HCPCS Level II E-code · short descriptor: “External ambulatory infus pu”

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.

E0781 Medicare fee schedule (April 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $309.33 to $396.36 depending on state and rural status.

State	Non-rural	Rural
AK	$380.71	—
AL	$309.33	$339.48
AR	$309.33	$343.40
AZ	$309.33	$329.83
CA	$309.33	$343.40
CO	$309.33	$343.40
CT	$309.33	$343.40
DC	$309.33	$343.40
DE	$309.33	$315.09
FL	$309.33	$327.43
GA	$309.33	$337.74
HI	$396.36	—
IA	$309.33	$343.40
ID	$309.33	$343.40
IL	$309.33	$343.40
IN	$309.33	$343.40
KS	$309.33	$343.40
KY	$309.33	$343.40
LA	$309.33	$343.40
MA	$309.33	$315.09
MD	$309.33	$338.42
ME	$309.33	$315.09
MI	$309.33	$340.96
MN	$309.33	$343.40
MO	$309.33	$343.40
MS	$309.33	$324.88
MT	$309.33	$326.15
NC	$309.33	$343.40
ND	$309.33	$324.59
NE	$309.33	$343.40
NH	$309.33	$315.09
NJ	$309.33	$315.09
NM	$309.33	$321.49
NV	$309.33	$334.05
NY	$309.33	$315.09
OH	$309.33	$343.40
OK	$309.33	$343.40
OR	$309.33	$343.40
PA	$309.33	$315.09
PR	$376.01	—
RI	$309.33	$319.45
SC	$309.33	$343.40
SD	$309.33	$339.75
TN	$309.33	$343.40
TX	$309.33	$343.40
UT	$309.33	$343.40
VA	$309.33	$315.09
VI	$343.40	—
VT	$309.33	$315.09
WA	$309.33	$343.40
WI	$309.33	$343.40
WV	$309.33	$332.14
WY	$309.33	$339.20

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

CO-50 medical necessity

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