HCPCS E0161 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Durable Medical Equipment • Sitz Bath/Equipment |
| Complexity Level | Low |
National average reimbursement for HCPCS E0161 by major payers:
$23.13
$17.93
$17.03
$36.42
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS E0161 | ||||||
United | E0161 | $1.97 | 1912099094 - COLQUITT REGIONAL MEDICAL CENTER | 580607088 - COLQUITT REGIONAL MEDICAL CENTER | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $37.38 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $17.04 | 1306890942 - BROOKS COUNTY HOSPITAL | 586002830 | GA | Critical Access Hospital (282NC0060X) |
United | E0161 | $1.97 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | E0161 | $10.44 | 1881144889 - NGMC BARROW LLC, NGMC BARROW | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $10.44 | 1417157405 - EMORY HEALTHCARE | 901116753 | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $20.97 | 1801844469 - AUGUSTA VAMC | 582089405 - AUGUSTA VAMC | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $51.43 | 1598964082 - EMORY HEALTHCARE | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $17.04 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $41.36 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $15.72 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | E0161 | $1.53 | 1417157405 - EMORY HEALTHCARE | 711018941 - CARDIAC ARRHYTHMIA INSTITUTE | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $1.97 | 1790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH | 582002413 | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $64.65 | 1588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E0161 | $17.04 | 1326028978 - CHATUGE REGIONAL HOSPITAL INC | 582513901 - CHATUGE REGIONAL HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS E0161 vs. Other Sitz Bath/Equipment Codes
The HCPCS E0161 code is part of the Durable Medical Equipment services used for Sitz Bath/Equipment. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS E0161 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| E0160-HCPCS | Low | Sitz type bath or equipment, portable, used with or without commode |
| E0161-HCPCS | Low | Sitz type bath or equipment, portable, used with or without commode, with faucet attachment/s |
| E0162-HCPCS | Low | Sitz bath chair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0161. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E0161 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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