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HCPCS E0580 · Level II · DME code

E0580: Nebulizer, durable, glass or autoclavable plastic, bottle type, 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); DMEPOS fee schedule: DME26-D (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 DMEPOS fee schedule 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 E0580

Medicare payment
$164.65
DMEPOS non-rural state fees (NU)
Coverage code
D
special coverage instructions apply
DME supplier MUE
1
MAI 3
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
2 / 0

TL;DR

HCPCS Level II E0580 reads "Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter" in the October 2026 file; it dates from 1986. E0580 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $164.65 in every contiguous state, rural $164.65; RR (rental) $16.47 in every contiguous state, rural $16.47; UE (purchased, used) $123.47 in every contiguous state, rural $123.47, October 2026. MUE limits for E0580: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 3, Nature of Equipment). 2 active LCDs list E0580: L33370 (Nebulizers), L33797 (Oxygen and Oxygen Equipment). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1E (other DME); pricing indicator 32; type of service P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). 3 other active codes open with "Nebulizer"; related codes: E0570, E0575, E0585, E0565.

E0580 descriptor and code status

The October 2026 HCPCS Level II file describes E0580 as “Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E0580
FieldValue
Short descriptorNebulizer for use w/ regulat
Added to HCPCS1986-01-01
Last actionN (no maintenance), effective 1998-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator32: DMEPOS inexpensive and routinely purchased DME (floors and ceilings)
BETOS categoryD1E: other DME
Type of serviceP: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME

Medicare payment for E0580

E0580 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $164.65 in every contiguous state, rural $164.65; RR (rental) $16.47 in every contiguous state, rural $16.47; UE (purchased, used) $123.47 in every contiguous state, rural $123.47, October 2026. 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.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category IN (inexpensive and other routinely purchased items). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for E0580 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
NU (purchased, new)—$164.65 (49 states)$164.65 (49 states)AK $164.65, HI $164.65, PR $182.27, VI $164.65
RR (rental)—$16.47 (49 states)$16.47 (49 states)AK $16.47, HI $16.47, PR $18.24, VI $16.47
UE (purchased, used)—$123.47 (49 states)$123.47 (49 states)AK $123.47, HI $123.47, PR $136.70, VI $123.47

Hospital outpatient (OPPS Addendum B)

Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.

Medically Unlikely Edits for E0580

MUE limits for E0580: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 3, Nature of Equipment). The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for E0580 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 supplier13 Date of Service Edit: ClinicalNature of Equipment

The MUE lookup for E0580 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E0580 in v323r0.

E0580 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 E0580 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E0580

2 active Local Coverage Determinations and 0 billing and coding articles list E0580. 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 E0580

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists E0580

CARC 151 · N362

units of E0580 exceed the DME supplier MUE of 1 per date of service

CARC 4

the NU, RR, UE payment modifier is missing or does not match the item

CARC 16

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

Where QuickIntell fits for E0580 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for E0580 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E0580

What does HCPCS code E0580 describe?

"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter" (short descriptor "Nebulizer for use w/ regulat"), in the E section (durable medical equipment). Added 1986-01-01; last action N (no maintenance) effective 1998-01-01.

Is E0580 a CPT code?

No: CMS maintains E0580 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.

What does Medicare pay for E0580?

E0580 is paid from the DMEPOS fee schedule as inexpensive and other routinely purchased items (IN): NU (purchased, new) $164.65 in every contiguous state, rural $164.65; RR (rental) $16.47 in every contiguous state, rural $16.47; UE (purchased, used) $123.47 in every contiguous state, rural $123.47, October 2026.

How many units of E0580 can be billed per day?

MUE limits for E0580: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 3, Nature of Equipment). For the DME supplier MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover E0580?

Coverage code D (special coverage instructions apply). 2 active LCDs list E0580: L33370 (Nebulizers), 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.