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HCPCS E0430 · Level II · DME code

E0430: Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, HCPCS Level II DME code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for E0430

Medicare payment
not separately priced
HCPCS pricing indicator 00 (Part B)
Coverage code
D
special coverage instructions apply
Practitioner MUE
0
MAI 3
OPPS status
SI E1
Non-allowed item or service
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

E0430 is a Level II code from the E section (durable medical equipment), in use since 1986: "Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing". Part B does not price E0430 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0430. MUE limits for E0430: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). 1 active LCD lists E0430: L33797 (Oxygen and Oxygen Equipment). OPPS status indicator E1: Non-allowed item or service. HCPCS record: BETOS D1C (oxygen and supplies); pricing indicator 00; type of service R (rental of DME). 1 other active code opens with "Portable gaseous oxygen system"; related codes: E0431, E0424, E0443, E0446.

E0430 descriptor and code status

The October 2026 HCPCS Level II file describes E0430 as “Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E0430
FieldValue
Short descriptorOxygen system gas portable
Added to HCPCS1986-01-01
Last actionN (no maintenance), effective 1993-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator00: not separately priced by Part B
BETOS categoryD1C: oxygen and supplies
Type of serviceR: rental of DME

Medicare payment for E0430

Part B does not price E0430 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0430. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Hospital outpatient (OPPS Addendum B)

Status indicator E1 (Non-allowed item or service), with no separate OPPS payment rate.

Medically Unlikely Edits for E0430

MUE limits for E0430: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for E0430 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier03 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for E0430 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E0430 in v323r0.

E0430 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check E0430 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E0430

1 active Local Coverage Determination and 0 billing and coding articles list E0430. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on E0430

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists E0430

CARC 151 · N362

units of E0430 exceed the practitioner MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for E0430 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for E0430 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E0430

What does HCPCS code E0430 describe?

"Portable gaseous oxygen system, purchase; includes regulator, flowmeter, humidifier, cannula or mask, and tubing" (short descriptor "Oxygen system gas portable"), in the E section (durable medical equipment). Added 1986-01-01; last action N (no maintenance) effective 1993-01-01.

Is E0430 a CPT code?

No: CMS maintains E0430 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.

What does Medicare pay for E0430?

Part B does not price E0430 separately: the HCPCS file gives it pricing indicator 00. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E0430.

How many units of E0430 can be billed per day?

MUE limits for E0430: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 0 (MAI 3, CMS Policy). For the practitioner MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover E0430?

Coverage code D (special coverage instructions apply). 1 active LCD lists E0430: L33797 (Oxygen and Oxygen Equipment).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.