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
- 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.
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
| State | Non-rural | Rural |
|---|---|---|
| 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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