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HCPCS K0609 · Level II · K code

K0609: Replacement electrodes for use with automated external defibrillator, garment type only, HCPCS Level II K 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 K0609

Medicare payment
$1,148.78
DMEPOS non-rural state fees
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
1
MAI 3
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

CMS describes HCPCS K0609, added in 2003, as "Replacement electrodes for use with automated external defibrillator, garment type only, each". The October 2026 DMEPOS fee schedule (category SU, supplies) sets K0609 at $1,148.78 in every contiguous state (floor $976.46, ceiling $1,148.78); KF (FDA class III device) $1,275.45 in every contiguous state (floor $1,084.13, ceiling $1,275.45). CMS caps K0609 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 3, Nature of Equipment) units per day in the 2026 Q4 MUE tables. 1 active LCD lists K0609: L33690 (Automatic External Defibrillators). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1E (other DME); pricing indicator 34; type of service P (lump-sum purchase of DME, prosthetics or orthotics). Nearby codes: K0606, K0738, K0800, K0821.

K0609 descriptor and code status

The October 2026 HCPCS Level II file describes K0609 as “Replacement electrodes for use with automated external defibrillator, garment type only, each”. It sits in the K section (temporary codes for DME Medicare administrative contractors), listed with the other K codes.

HCPCS file attributes of K0609
FieldValue
Short descriptorRepl electrode for aed
Added to HCPCS2003-07-01
Last actionN (no maintenance), effective 2003-07-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator34: DMEPOS DME supplies (floors and ceilings)
BETOS categoryD1E: other DME
Type of serviceP: lump-sum purchase of DME, prosthetics or orthotics

Medicare payment for K0609

The October 2026 DMEPOS fee schedule (category SU, supplies) sets K0609 at $1,148.78 in every contiguous state (floor $976.46, ceiling $1,148.78); KF (FDA class III device) $1,275.45 in every contiguous state (floor $1,084.13, ceiling $1,275.45). 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 SU (supplies). 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 K0609 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
none$976.46 / $1,148.78$1,148.78 (49 states)—AK $1,148.78, HI $1,148.78, PR $1,378.59, VI $1,148.78
KF (FDA class III device)$1,084.13 / $1,275.45$1,275.45 (49 states)—AK $1,275.45, HI $1,275.45, PR $1,530.56, VI $1,275.45

Hospital outpatient (OPPS Addendum B)

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

Medically Unlikely Edits for K0609

CMS caps K0609 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 3, Nature of Equipment) units per day in the 2026 Q4 MUE tables. 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 K0609 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 K0609 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists K0609 in v323r0.

K0609 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 K0609 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for K0609

1 active Local Coverage Determination and 0 billing and coding articles list K0609. 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 K0609

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists K0609

CARC 151 · N362

units of K0609 exceed the DME supplier MUE of 1 per date of service

CARC 4

the KF 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

For teams evaluating QuickIntell software

Where QuickIntell fits for K0609 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for K0609 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-up
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Optional software evaluation, not payer support or help with an individual claim. For coverage or payment decisions, use the official sources on this page. Do not include patient information in a demo booking or inquiry.

Frequently asked questions: HCPCS K0609

What does HCPCS code K0609 describe?

"Replacement electrodes for use with automated external defibrillator, garment type only, each" (short descriptor "Repl electrode for aed"), in the K section (temporary codes for DME Medicare administrative contractors). Added 2003-07-01.

Is K0609 a CPT code?

It is not. K0609 belongs to the K section (temporary codes for DME Medicare administrative contractors) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for K0609?

The October 2026 DMEPOS fee schedule (category SU, supplies) sets K0609 at $1,148.78 in every contiguous state (floor $976.46, ceiling $1,148.78); KF (FDA class III device) $1,275.45 in every contiguous state (floor $1,084.13, ceiling $1,275.45).

How many units of K0609 can be billed per day?

CMS caps K0609 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 3, Nature of Equipment) units per day in the 2026 Q4 MUE tables. 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 K0609?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists K0609: L33690 (Automatic External Defibrillators).

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.