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See a sample rate comparisonHCPCS E0604 Fee Schedule
Last Verified: October 2026
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.
Breast pump, hospital grade, electric (AC and / or DC), any type
| Key Fact | Detail |
|---|---|
| Service Type | Durable Medical Equipment Breast Pumps |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $62.60 median of the 4 states in the free preview · View Medicaid rates for E0604 |
National average reimbursement for HCPCS E0604 by major payers:
$222.46
$140.28
$111.20
$333.72
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HCPCS E0604
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$303.26Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$161.29Published rateNortheast Georgia Medical Center, Inc.
Gainesville Radiology Group
$120.61Published rateMonroe Hma, LLC, Clearview Regional Medical Center
Monroe Hma LLC
$105.31Published rateSt. Francis Radiologists, LLC
$46.13Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS E0604 vs. Other Breast Pumps Codes
The HCPCS E0604 code is part of the Durable Medical Equipment services used for Breast Pumps. 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 E0604 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 |
|---|---|---|
| E0603-HCPCS | Low | Breast pump, electric (AC and/or DC), any type |
| E0604-HCPCS | Moderate | Breast pump, hospital grade, electric (AC and / or DC), any type |
| E0605-HCPCS | Low | Vaporizer, room type |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E0604 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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