HCPCS Level II E0603: Electric Breast Pump, Durable Medical Equipment
HCPCS Level II code E0603 describes an electric breast pump (AC and/or DC) intended as durable medical equipment for lactation support; the service involves provision of an electric breast pump for use by a patient, typically supplied for home use or outpatient/ambulatory settings to assist with milk expression.
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
National commercial reimbursement for HCPCS E0603 centers on BUCA’s average commercial rate of $104.40, which serves as a mid-market reference point among major commercial payers. Blue Cross Blue Shield displays the largest dispersion (P75 $195.70 minus P25 $60.10 = $135.60), indicating wide variability in higher-end contracted rates, while Aetna and Cigna show much tighter spreads (Aetna P75 $136.00 minus P25 $17.00 = $119.00; Cigna P75 $80.70 minus P25 $9.00 = $71.70). UnitedHealth Group’s spread (P75 $105.00 minus P25 $41.30 = $63.70) is the narrowest, reflecting more consistency around its median.
Examining central tendency, Blue Cross Blue Shield and UnitedHealth Group have higher medians ($126.20 and $75.40 respectively) than Cigna and Aetna, with BUCA’s mean of $104.40 positioned between these payers’ means. The pronounced dispersion at Blue Cross Blue Shield suggests greater contractual variability at the upper quartile, whereas UnitedHealth Group’s relatively small interquartile range signals tighter alignment of commercial rates around its core pricing.