E0785 HCPCS code: Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement
E0785 is the HCPCS Level II code for implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement. The 2026 Medicare DMEPOS fee schedule pays $572.38 to $673.39 (KF, FDA Class III device) depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 1999-01-01 |
| Last action effective | 1999-01-01 |
2026 Medicare DMEPOS fee schedule for E0785
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| KF | FDA Class III device | $572.38 | $673.39 | $673.39 | $572.38 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AL | KF | $673.39 | — |
| AR | KF | $673.39 | — |
| AZ | KF | $673.39 | — |
| CA | KF | $673.39 | — |
| CO | KF | $673.39 | — |
| CT | KF | $572.38 | — |
| DC | KF | $673.39 | — |
| DE | KF | $673.39 | — |
| FL | KF | $673.39 | — |
| GA | KF | $673.39 | — |
| IA | KF | $673.39 | — |
| ID | KF | $572.38 | — |
| IL | KF | $673.39 | — |
| IN | KF | $572.38 | — |
| KS | KF | $602.48 | — |
| KY | KF | $572.38 | — |
| LA | KF | $673.39 | — |
| MA | KF | $673.39 | — |
| MD | KF | $673.39 | — |
| ME | KF | $673.39 | — |
| MI | KF | $673.39 | — |
| MN | KF | $673.39 | — |
| MO | KF | $602.48 | — |
| MS | KF | $673.39 | — |
| MT | KF | $673.39 | — |
| NC | KF | $572.38 | — |
| ND | KF | $673.39 | — |
| NE | KF | $602.48 | — |
| NH | KF | $673.39 | — |
| NJ | KF | $572.38 | — |
| NM | KF | $673.39 | — |
| NV | KF | $673.39 | — |
| NY | KF | $613.56 | — |
| OH | KF | $673.39 | — |
| OK | KF | $673.39 | — |
| OR | KF | $673.39 | — |
| PA | KF | $572.38 | — |
| RI | KF | $572.38 | — |
| SC | KF | $572.38 | — |
| SD | KF | $673.39 | — |
| TN | KF | $572.38 | — |
| TX | KF | $673.39 | — |
| UT | KF | $673.39 | — |
| VA | KF | $673.39 | — |
| VT | KF | $673.39 | — |
| WA | KF | $673.39 | — |
| WI | KF | $673.39 | — |
| WV | KF | $673.39 | — |
| WY | KF | $673.39 | — |
How the E0785 fee compares
| Measure | Value |
|---|---|
| Rank among 1 E07 codes billed KF (lowest = 1) | 1 |
| Family fee range (average of state fees) | $647.21–$647.21 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | CMS Policy |
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))
Covered diagnoses (2,477 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C91.00 | Acute lymphoblastic leukemia not having achieved remission | 2 |
| C91.01 | Acute lymphoblastic leukemia, in remission | 2 |
| C91.02 | Acute lymphoblastic leukemia, in relapse | 2 |
| A18.01 | Tuberculosis of spine | 1 |
| B02.23 | Postherpetic polyneuropathy | 1 |
| C00.0 | Malignant neoplasm of external upper lip | 1 |
| C00.1 | Malignant neoplasm of external lower lip | 1 |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | 1 |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | 1 |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | 1 |
Showing 10 of 2,477. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for E0785
- 2026-01-01: Average state fee (KF) rose 2.0%: $634.53 to $647.21
- 1999-01-01: E0785 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 E0785?
E0785 is the HCPCS Level II code for implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement. Short descriptor: "Replacement impl pump cathet".
How much does Medicare pay for E0785?
Under the 2026 DMEPOS fee schedule, non-rural state fees are KF (FDA Class III device): $572.38–$673.39. Rural fees can be higher.
Does Medicare cover E0785?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for E0785?
Medicare policy articles that cite E0785 list 2,477 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include C91.00 (Acute lymphoblastic leukemia not having achieved remission), C91.01 (Acute lymphoblastic leukemia, in remission), C91.02 (Acute lymphoblastic leukemia, in relapse). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for E0785 change in 2026?
The average non-rural state fee for KF moved from $634.53 in 2025 to $647.21 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0785 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related E07 codes
- E0700 — Safety equipment, device or accessory, any type
- E0705 — Transfer device, any type, each ($5.34–$134.77)
- E0710 — Restraints, any type (body, chest, wrist or ankle)
- E0711 — Upper extremity medical tubing/lines enclosure or covering device, restricts elbow range of motion
- E0715 — Intravaginal device intended to strengthen pelvic floor muscles during kegel exercises
- E0716 — Supplies and accessories for intravaginal device intended to strengthen pelvic floor muscles during kegel exercises
- E0720 — Transcutaneous electrical nerve stimulation (TENS) device, two lead, localized stimulation ($66.89–$393.27)
- E0721 — Transcutaneous electrical nerve stimulator for nerves in the auricular region
- E0730 — Transcutaneous electrical nerve stimulation (TENS) device, four or more leads, for multiple nerve stimulation ($68.53–$425.83)
- E0731 — Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) ($87.58–$480.99)
- E0732 — Cranial electrotherapy stimulation (ces) system, any type ($31.06–$69.51)
- E0733 — Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve ($31.06–$69.51)
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 E0785
- Watch E0785 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0785
Sources: CMS HCPCS Level II release October 2025; 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.