E0469 HCPCS code: Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device
E0469 is the HCPCS Level II code for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device. The 2026 Medicare DMEPOS fee schedule pays $1,559.78 to $1,880.52 (RR, rental (monthly)) depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers. In 2024, 6 suppliers billed Medicare for E0469 (rentals), serving 139 beneficiaries; Colorado, California, Texas accounted for 73% of services. Its average fee ranks 19 of 19 E04 codes billed RR (family range $5.28–$1,572.12).
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 36 — DMEPOS: capped rental item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2024-10-01 |
| Last action effective | 2024-10-01 |
2026 Medicare DMEPOS fee schedule for E0469
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $1,559.78 | $1,880.52 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $1,575.74 | — |
| AL | RR | $1,566.36 | — |
| AR | RR | $1,567.42 | — |
| AZ | RR | $1,563.71 | — |
| CA | RR | $1,564.79 | — |
| CO | RR | $1,567.38 | — |
| CT | RR | $1,567.44 | — |
| DC | RR | $1,567.31 | — |
| DE | RR | $1,566.09 | — |
| FL | RR | $1,563.10 | — |
| GA | RR | $1,565.89 | — |
| HI | RR | $1,565.75 | — |
| IA | RR | $1,567.42 | — |
| ID | RR | $1,567.38 | — |
| IL | RR | $1,567.48 | — |
| IN | RR | $1,567.48 | — |
| KS | RR | $1,567.42 | — |
| KY | RR | $1,567.42 | — |
| LA | RR | $1,566.52 | — |
| MA | RR | $1,567.44 | — |
| MD | RR | $1,564.41 | — |
| ME | RR | $1,567.44 | — |
| MI | RR | $1,565.25 | — |
| MN | RR | $1,567.42 | — |
| MO | RR | $1,567.42 | — |
| MS | RR | $1,562.12 | — |
| MT | RR | $1,562.36 | — |
| NC | RR | $1,567.42 | — |
| ND | RR | $1,562.33 | — |
| NE | RR | $1,567.42 | — |
| NH | RR | $1,567.44 | — |
| NJ | RR | $1,564.17 | — |
| NM | RR | $1,561.46 | — |
| NV | RR | $1,564.69 | — |
| NY | RR | $1,565.76 | — |
| OH | RR | $1,567.48 | — |
| OK | RR | $1,567.38 | — |
| OR | RR | $1,567.21 | — |
| PA | RR | $1,565.18 | — |
| PR | RR | $1,880.52 | — |
| RI | RR | $1,559.78 | — |
| SC | RR | $1,565.53 | — |
| SD | RR | $1,566.44 | — |
| TN | RR | $1,564.23 | — |
| TX | RR | $1,567.38 | — |
| UT | RR | $1,567.38 | — |
| VA | RR | $1,564.57 | — |
| VI | RR | $1,568.76 | — |
| VT | RR | $1,567.44 | — |
| WA | RR | $1,567.21 | — |
| WI | RR | $1,567.48 | — |
| WV | RR | $1,565.70 | — |
| WY | RR | $1,566.24 | — |
How the E0469 fee compares
| Measure | Value |
|---|---|
| Rank among 19 E04 codes billed RR (lowest = 1) | 19 |
| Family fee range (average of state fees) | $5.28–$1,572.12 |
| Rural fee uplift | — |
Who bills E0469 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | 6 |
| Suppliers billing purchases | — |
| Referring clinicians | 111 |
| Medicare beneficiaries | 139 |
| States with claims | 6 |
| Share of services in top 3 states (Colorado, California, Texas) | 73% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E0469, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 299 | 139 | $1,279.94 | $1,003.47 |
States with the most E0469 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Colorado | 53 | $1,003.54 |
| California | 51 | $1,013.37 |
| Texas | 37 | $993.45 |
| Minnesota | 18 | $1,013.12 |
| Illinois | 18 | $1,078.52 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
What changed for E0469
- 2026-01-01: Average state fee (RR) rose 2.0%: $1,541.28 to $1,572.12
- 2024-10-01: E0469 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code E0469?
E0469 is the HCPCS Level II code for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device. Short descriptor: "Lung expans high oscil neb".
How much does Medicare pay for E0469?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $1,559.78–$1,880.52. Rural fees can be higher.
Does Medicare cover E0469?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for E0469 change in 2026?
The average non-rural state fee for RR moved from $1,541.28 in 2025 to $1,572.12 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0469 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related E04 codes
- E0424 — Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing ($94.56–$177.16)
- E0425 — Stationary compressed gas system, purchase; includes regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
- E0430 — Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing
- E0431 — Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing ($21.24–$88.58)
- E0433 — Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge ($46.28–$88.58)
- E0434 — Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing ($46.28–$88.58)
- E0435 — Portable liquid oxygen system, purchase; includes portable container, supply reservoir, flowmeter, humidifier, contents gauge, cannula or mask, tubing and refill adaptor
- E0439 — Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing ($94.56–$177.16)
- E0440 — Stationary liquid oxygen system, purchase; includes use of reservoir, contents indicator, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing
- E0441 — Stationary oxygen contents, gaseous, 1 month's supply = 1 unit ($61.92–$75.90)
- E0442 — Stationary oxygen contents, liquid, 1 month's supply = 1 unit ($61.92–$75.90)
- E0443 — Portable oxygen contents, gaseous, 1 month's supply = 1 unit ($56.56–$72.51)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under E0469
- Watch E0469 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0469
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.