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HCPCS E0243 Fee Schedule

Last Verified: December 2025

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.

Toilet rail, each
Key FactDetail
Service Type

Durable Medical Equipment

Bathing Supplies

Complexity LevelLow

National average reimbursement for HCPCS E0243 by major payers:

bcbs

$28.38

uhc

$27.24

aetna

$26.65

cigna

$45.30

Preview provider-level rates for...
For billing codeHCPCS E0243
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS E0243

United
E0243$98.391073502985 - CHU CHEN42484572MAPediatrics Physician (208000000X)
United
E0243$103.071073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
E0243$103.071073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
E0243$22.611962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER711045290 - (GA) HOUSTON HOSPITALS INCGAGeneral Acute Care Hospital (282N00000X)
United
E0243$40.951992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL263792403 - PHOEBE PHYSICIAN GROUP INCGAGeneral Acute Care Hospital (282N00000X)
United
E0243$31.401922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE580572465 - CHILDRENS HEALTHCARE OF ATLANTA INCGAChildren's Hospital (282NC2000X)
United
E0243$50.431225281603 - EMORY CRAWFORD LONG HOSPITAL581537752 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
E0243$28.211194779702 - JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.580566121 - JOHN D ARCHBOLD MEMORIAL HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
E0243$54.471255891958 - PIEDMONT NEWTON EKG BILLING LLC814475074 - (GA) PIEDMONT NEWTON HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
E0243$23.501730110826 - EVANS MEMORIAL HOSPITAL, INC.582257925 - (GA) EVANS MEMORIAL HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
E0243$22.601255891958 - PIEDMONT NEWTON EKG BILLING LLC582155150 - (GA) PIEDMONT NEWTON HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
E0243$54.471306136551 - UJUKA ILOABUCHI881014763GAWomen's Hospital (282NW0100X)
United
E0243$23.551831538743 - JACOB HOLLOWAY273818647GAGeneral Acute Care Hospital (282N00000X)
United
E0243$23.551306136551 - UJUKA ILOABUCHI582422542 - ATLANTA WOMENS HEALTH GROUP, P.C.GAWomen's Hospital (282NW0100X)
United
E0243$32.901770684284 - THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA, MONROE COUNTY HOSPITAL586010602 - (GA) THE HOSPITAL AUTHORITY OF MONROE COUNTY GEORGIAGACritical Access Hospital (282NC0060X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS E0243 vs. Other Bathing Supplies Codes

The HCPCS E0243 code is part of the Durable Medical Equipment services used for Bathing Supplies. 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 E0243 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.

CodeComplexityDescription
E0242-HCPCSLowBath tub rail, floor base
E0243-HCPCSLowToilet rail, each
E0244-HCPCSLowRaised toilet seat

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0243. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the E0243 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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