HCPCS Level II E0784: External Ambulatory Infusion Pump, Insulin
Commercial payers pay $2863 on average nationally for this procedure.
HCPCS Level II code E0784 describes an external ambulatory infusion pump for insulin used to deliver subcutaneous insulin in an outpatient or ambulatory setting; the service is insulin infusion pump therapy typically provided in home health, outpatient clinic, or ambulatory infusion centers where a portable pump administers ongoing insulin therapy for diabetes management.
For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.
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National Reimbursement Benchmarks
Commercial rates for HCPCS E0784 cluster around BUCA’s average-commercial benchmark of $2,863.30, with payers showing meaningful dispersion in mid-to-high percentiles. Blue Cross Blue Shield and Cigna have higher medians near $3,625.80 and $3,041.20 respectively, while Aetna and UnitedHealth Group sit lower around $1,643.20 and $1,800.80; BUCA’s median-equivalent (P50 $2,999.80) sits between those groups, indicating the market center is closer to BUCA and Cigna/BCBS than to Aetna or UnitedHealth Group.
Rate dispersion (P75 minus P25) highlights variability: Blue Cross Blue Shield’s interquartile range is $2,871.50 (P75 $4,646.60 minus P25 $1,775.10), the widest, followed by Cigna at $1,531.80 and BUCA at $2,330.30. Aetna’s IQR is $2,226.00 and UnitedHealth Group’s is $1,072.10, the tightest, signaling relatively more consistency from UnitedHealth Group versus much broader pricing spreads at Blue Cross Blue Shield.