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E0785 — Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement

HCPCS Level II E-code · short descriptor: “Replacement impl pump cathet”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Inexpensive or routinely purchased
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required 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.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

E0785 Medicare fee schedule (April 2026)

KF Inexpensive or routinely purchased

Medicare allowable ranges from $572.38 to $673.39 depending on state and rural status.

Former-CBA payment limits: ceiling $673.39 · floor $572.38

StateNon-ruralRural
AL$673.39
AR$673.39
AZ$673.39
CA$673.39
CO$673.39
CT$572.38
DC$673.39
DE$673.39
FL$673.39
GA$673.39
IA$673.39
ID$572.38
IL$673.39
IN$572.38
KS$602.48
KY$572.38
LA$673.39
MA$673.39
MD$673.39
ME$673.39
MI$673.39
MN$673.39
MO$602.48
MS$673.39
MT$673.39
NC$572.38
ND$673.39
NE$602.48
NH$673.39
NJ$572.38
NM$673.39
NV$673.39
NY$613.56
OH$673.39
OK$673.39
OR$673.39
PA$572.38
RI$572.38
SC$572.38
SD$673.39
TN$572.38
TX$673.39
UT$673.39
VA$673.39
VT$673.39
WA$673.39
WI$673.39
WV$673.39
WY$673.39
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

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