Deep ResearchBuyer GuideOctober 5, 2026 · 29 min read · VEMERIX

Medicare Home NPWT Fees in October 2026: The ZIP-Code Check Behind an E2402 Benchmark

Unchanged fee cells can still produce a different benchmark when a ZIP changes rural status.

NPWTMedicare
Sealed wound-care supplies, a calculator and a folded map representing geographic fee comparisons

One ZIP selects a benchmark from three relevant columns

The CMS fee-schedule index links DME26-C for July and DME26-D for October 2026. Both source archives were retrieved and independently checked for this review. The selected rows and quarterly ZIP lists, rather than the index page's general modification timestamp, determine the comparison. 7

ZIP 10001: Bronx E2402 RR $652.56, New York non-rural $832.93, New York rural $1,504.41
Bronx former CBAE2402 RR: 652.56652.56New York non-ruralE2402 RR: 832.93832.93New York ruralE2402 RR: 1,504.411,504.41
View chart data
CategoryE2402 RR
Bronx former CBA652.56
New York non-rural832.93
New York rural1504.41

The former-CBA ZIP file assigns 10001 to Bronx, NY. The ZIP is on neither the quarter 3 nor the quarter 4 rural list. July and October print the same three pump amounts.

Source: CMS July 2026 former CBA fee schedule and ZIP file (DME26-C) and July 2026 state fee table — VEMERIX analysis, accessed 4 October 2026. https://www.cms.gov/files/zip/dme26-c.zip

ZIP 10001: Bronx E2402 RR $652.56, New York non-rural $832.93, New York rural $1,504.41. The former-CBA list assigns the ZIP to Bronx. July and October print the same three pump amounts.

The pump is the part of the quote that moves. Bronx $652.56 is $180.37 below the New York non-rural cell and $851.85 below the New York rural cell. The rural cell is $671.48 above the non-rural cell. The dressing gap from Bronx to the New York non-rural cell is $0.30. The canister gap, from A7000 NU KG $9.81 to A7000 NU $9.83, is $0.02. Adding one of each cell, the Bronx total is $693.83, the New York non-rural total is $874.52, and the New York rural total is $1,548.34. The one-each gap from Bronx to the non-rural row is $180.69. The gap from Bronx to the rural row is $854.51. Those sums are one rental-month cell plus one dressing set plus one canister. Actual consumption and duration require a separate utilization model. 1 2

The ZIP lists select the Bronx cell. The dressing and the canister move by cents on the same fork, and the former-CBA canister row carries the KG modifier the state row leaves blank. October prints the same three pump amounts. 4 5

A state name is the wrong lookup key. The New York state columns print $832.93 and $1,504.41. The former-CBA file prints nine New York columns. Bronx, at $652.56, is the low column. The other eight run from Port Chester at $840.90 to Buffalo and Syracuse at $876.36. ZIP 12207 is Albany, $868.02, and that ZIP is on neither rural list. Those nine columns are in the former-CBA section, with the dressing and the canister. ZIP 10001 selects the Bronx row alone. 1 2 5

The printed cell is a fee-schedule amount

The Bronx and New York amounts above are July fee cells, and the October file prints the same cells on E2402 RR, A6550, A7000 NU, and A7000 NU KE. 2 4

CMS's payment-policy page and the public-use-file background distinguish the fee-schedule amount from the supplier's charge and the Medicare payment. Payment depends on the lower applicable charge or schedule amount, beneficiary deductible and coinsurance, and other relevant payment adjustments. The tables here reproduce the schedule amounts before applying those claim-level factors. A fee cell is therefore a benchmark for the lookup, not a supplier selling price, acquisition cost or guaranteed remittance. 8 9

A pricing worksheet should keep separate fields for the CMS schedule amount, submitted charge, expected allowed amount, Medicare payment and beneficiary responsibility. Leaving later fields pending is more accurate than labeling the full fee cell “Medicare pays.” This report calculates differences between published cells; it leaves adjudication to the supplier's current Medicare billing process.

E2402 is category CR, capped rental, with DME MAC jurisdiction D. DMEBACK describes the general capped-rental framework for this class, other than power wheelchairs: a maximum of 13 months of continuous use when covered, with the first three monthly fee amounts based on 10 percent of the updated base-year purchase price and later months at 75 percent of those initial amounts. The month-4 example below is a calculation from the published fee cell. 9

That general rental framework must be read alongside NPWT-specific continued-coverage rules. Article A52511 discusses documentation and review for therapy beyond four months on the most recent wound. The 13-month category maximum therefore supplies no automatic entitlement to 13 months of covered NPWT. 6

The ceiling and floor fields are $0.00 on E2402 RR, A6550, A7000 NU and A7000 NU KE. DMEREAD explains that those fields are zero-filled for codes adjusted using competitive-bidding information. The actual geographic fees remain in their own columns. Read $1,504.41 from the contiguous rural pump column, and keep the zero-filled ceiling field separate. This avoids turning a file-layout convention into a zero reimbursement benchmark. 10

E2403 RR, added in the October file, is the contrast on that field. Its short description is “Ext oculr neg pres pump.” The ceiling is $1,352.58, the floor is $1,149.69, the New York non-rural cell equals the ceiling, and the New York rural cell is $0.00. 4 The NPWT rows have the opposite fill: a zero ceiling and a populated contiguous rural column.

VEMERIX's hospital total-cost model discusses a different purchasing decision and includes other-payer examples. This report uses only the identified Medicare schedule cells. Keep payer, care setting and date explicit when transferring a benchmark into a commercial model. 11

Which list selects the cell

ZIP 10001 is on the former-CBA list as Bronx, NY, and on neither the quarter 3 nor the quarter 4 rural ZIP list, so the lists select the Bronx cells. 1 3 5

DMEREAD tells the reader what the quarterly file is for. “Effective January 1, 2016, a quarterly rural ZIP Code file will be used to determine rural fee schedule payment applicability for codes with rural and non-rural adjusted fee schedule amounts based on information from competitive bidding program (CBPs).” The fee file itself “contains a fee schedule amount, floor and ceiling (where applicable), jurisdiction, and category for each unique combination of procedure code, modifier code (where applicable), and state.” 10 The rural file’s columns are STATE, DMEPOS RURAL ZIP CODE, and YEAR/QTR. Quarter 3 is coded 202603 and contains 15,909 ZIPs. Quarter 4 is coded 202604 and contains 15,907 ZIPs. 3 5

CMS describes a temporary competitive-bidding gap following the expiration of Round 2021 contracts for off-the-shelf back and knee braces on 31 December 2023. Its October update explains how former-CBA amounts and ZIP files are used during that gap. The brace-contract history is policy context for the gap period, separate from the historical NPWT category. The analysis below uses the published NPWT amounts directly, without independently reconstructing their historical inflation adjustments. 12 13

The former-CBA ZIP file has its own columns: CBA State, CBA ZIP Code, CBA Name Short, CBA Name, and Year/Qtr. July is coded 202603 and October is coded 202604. Both files contain 16,124 ZIPs, no ZIP mapped to two short names, the same ZIPs, and the same short names. Comparing either of those ZIP sets with either rural list produces an overlap of zero. 1 3 5

The two lists are disjoint in these releases. For an ordinary fee-file lookup, after establishing the address and ZIP used to price the claim, the sequence is:

  1. If the ZIP is on the former-CBA list, copy that short name’s E2402 RR, A6550, and A7000 NU KG.
  2. If the ZIP is on that quarter’s rural list, copy the state rural columns of E2402 RR, A6550, and A7000 NU.
  3. If the ZIP is on neither list, copy the state non-rural columns of those same three rows.

The state in step 3 comes from the verified address used for pricing. The two lists alone supply no state for a ZIP absent from both, so retain that address information separately. ZIPs 13601 and 14850 are on none of the four lists. Where the address is in New York, the cells are the New York non-rural amounts $832.93, $31.76, and $9.83. 2 3 5

DMEREAD also defines the rural ZIP for the file. “A geographic area represented by a postal zip code of at least 50 percent of the total geographic area of the area included in the zip code is estimated to be outside any metropolitan area (MSA). The definition of rural area also includes a geographic area represented by a postal zip code that is a low population density area excluded from a competitive bidding area in accordance with 42 CFR §414.210(g).” 10 The published rural list and the published former-CBA list share no ZIP in these two quarters. That is a fact about the two lists. The definition itself includes a low-population-density ZIP excluded from a CBA, so list membership is the test the fee file tells you to run.

DMEBACK describes distinct non-CBA methodologies: fully adjusted amounts for non-rural contiguous areas, and a blend of adjusted and unadjusted amounts for rural and noncontiguous areas. The worksheet reads the resulting published cells directly. Reconstructing the blend, inflation history or a multiplier between columns would be a separate calculation with additional inputs. 9

The rural column with no ZIP on the list

The District of Columbia, New Jersey, and Rhode Island each have a rural E2402 RR cell of $1,504.41. Each has zero rows in the quarter 3 rural file and zero rows in the quarter 4 rural file. 2 3 5 The fee-file cell exists, but neither quarterly rural list supplies a ZIP in those jurisdictions to select it.

Rhode Island’s non-rural pump is $748.28, the lowest contiguous non-rural amount, with dressing $31.67 and canister $10.09. New Jersey’s non-rural cells match New York: $832.93, $31.76, and $9.83. The District of Columbia matches that same non-rural triple. A ZIP in one of those three areas that is also on a former-CBA list uses the CBA column. A ZIP in one of them that is on neither list uses the non-rural column. The rural column remains on the row for a list that, in these two quarters, has no ZIP in that area.

Alaska, Hawaii, Puerto Rico and the Virgin Islands illustrate another layout convention. DMEREAD excludes these noncontinental areas from rural fees, so their rural columns are $0.00 on the three principal rows. The relevant state non-rural pump cells are $1,517.02 in Alaska, Hawaii and the Virgin Islands, and $1,727.82 in Puerto Rico, subject to the former-CBA lookup where applicable. Preserve these separate geographic branches instead of substituting a contiguous-state maximum or a rural-column zero. 10 2

For example, ZIP 96701 selects Honolulu in the former-CBA list and has a pump fee of $928.17. The Hawaii state non-rural comparator is $1,517.02. Both are populated schedule amounts for different lookup branches; the rural-column zero belongs to neither branch. The worksheet retains the corresponding dressing and canister amounts. 1 2 5

Fifteen former-CBA ZIP values are below 00501, including 00041 labeled Miami, FL. They appear in both files and were excluded from worked address examples. These unusual values deserve address validation before operational use; the comparison makes no claim about their postal validity. 1 5

A7000 NU KE is a different canister row

A7000 NU KE is $0.00 in all 49 contiguous non-rural cells and a positive rural amount from $11.04 to $12.43. Those rural KE cells differ from the A7000 NU rural cells in all 49 contiguous areas. New York is $0.00 non-rural and $11.04 rural on the KE row, against $9.83 and $10.23 on the NU row. October matches this row. 2 4

New York A7000 NU KE is $0.00 non-rural and $11.04 rural; NU is $9.83 and $10.23
NU non-ruralNew York fee cell: 9.839.83NU ruralNew York fee cell: 10.2310.23NU KE non-ruralNew York fee cell: 00NU KE ruralNew York fee cell: 11.0411.04
View chart data
CategoryNew York fee cell
NU non-rural9.83
NU rural10.23
NU KE non-rural0
NU KE rural11.04

The KE non-rural cell is $0.00 in all 49 contiguous areas. The KE rural cell runs from $11.04 to $12.43 and equals the NU rural cell in none of those 49 areas. October prints the same KE row.

Source: CMS July 2026 state fee table and October 2026 state fee table, A7000 NU and A7000 NU KE, New York columns — VEMERIX analysis, accessed 4 October 2026. https://www.cms.gov/files/zip/dme26-c.zip and https://www.cms.gov/files/zip/dme26-d.zip

New York A7000 NU KE is $0.00 non-rural and $11.04 rural; NU is $9.83 and $10.23. The same KE split, $0.00 non-rural and a different positive rural amount, holds in all 49 contiguous areas. October prints the same row.

DMEREAD Attachment A-1 defines the modifiers on these rows. “NU--Purchased, New.” “RR--Rented.” “KE--Bid Under Round I of the DMEPOS Competitive Bid Program For Use With Non-Competitive Bid Base Equipment.” 10 The July and October state files, for these three HCPCS codes, contain E2402 RR, A6550 with both modifiers blank, A7000 NU, and A7000 NU KE. Jurisdiction on each is D, “D--DMEMAC jurisdiction.” E2402 is category CR, capped rental. A6550 is category SU, supplies. Both A7000 rows are category IN, inexpensive and other routinely purchased items. The short descriptions are “Neg press wound therapy pump,” “Neg pres wound ther drsg set,” and “Disposable canister for pump.” The KE row uses that same canister description. 2 4 10

The $0.00 KE cells are filled amounts, not blank cells. There are 49 of them in the contiguous non-rural columns and zero positive values among them. The rural KE amounts are filled and positive. The six areas at the bottom of that rural range, $11.04, are Delaware, New Hampshire, New Jersey, New York, Pennsylvania, and Rhode Island. In each of those six the NU rural cell is $10.23. The gap at the bottom of the range is $0.81, and it is still a different cell. Copying KE because it is the other canister line does two different things. On a contiguous non-rural quote it replaces a positive NU amount, $9.83 to $10.93, with $0.00. On a contiguous rural quote it replaces the NU rural amount with a higher KE amount, $11.04 to $12.43. 2

Alaska, Hawaii, Puerto Rico, and the Virgin Islands have positive KE non-rural amounts: $9.97, $10.68, $13.39, and $11.04. Their KE rural column is $0.00, the same non-continental layout as the NU rural column. An Alaska non-rural NU canister is $9.24. The Alaska KE non-rural cell, $9.97, is a different printed amount. 2 10

The KE amounts are observations about a separate modifier row. Actual modifier applicability requires current coding instructions and the equipment context. A zero cell supplies no claim-denial rate, and a higher rural KE amount supplies no reason to select KE for a standard NPWT quote.

The former-CBA canister has a third fee-file label, A7000 NU KG, category IN. Chapter 36's historical modifier table associates KG with a competitive-bidding product grouping. In the current fee files, the matching Bronx canister cell is $9.81, while the state-file NU row supplies the rural and non-rural amounts. The combination identifies the dataset row; a complete claim requires current MAC modifier instructions, including applicable coverage-related modifiers. 14 6

The state file contains E2402 RR rather than NU or UE purchase rows, and the selected canister rows are NU rather than RR. These are observations about the public-use file's contents. DMEREAD explicitly separates inclusion of a fee from coverage eligibility, so a supplier must establish the relevant benefit and billing rules independently. 10

Contiguous amounts, the same in July and October

The October 2026 file leaves every fee cell on E2402 RR, A6550, A7000 NU, and A7000 NU KE unchanged from July. 2 4 The same state fee values are available in both quarters; the applicable ZIP membership must still be checked for the date of service. The groupings below are equal-dollar groups derived from the data. They describe the observed cells rather than named CMS regions.

The denominator for every contiguous range below is 49 areas, Alabama through Wyoming including the District of Columbia. On these four rows every one of those cells is filled. None is blank. The noncontiguous areas, Alaska, Hawaii, Puerto Rico, and the Virgin Islands, are kept in their own block.

DMEBACK describes the contiguous CBP adjustment this way: “The average of Single Payment Amounts from CBPs located in eight different regions of the contiguous United States are used to establish the fee schedule amounts for the states located in each of the eight regions.” 9 E2402 RR has eight distinct contiguous non-rural amounts. Eight identical values are consistent with that description. A6550 has seven. A7000 NU has nine. The number of unique amounts differs across the three codes, so infer each component's value from its own row. The ceiling column on the pump row remains $0.00.

E2402 RR

Contiguous rural E2402 RR is $1,504.41 in all 49 areas. The eight non-rural amounts are:

E2402 RR, non-ruralAreasCount
748.28Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, Vermont6
752.89Colorado, Idaho, Montana, Utah, Wyoming5
792.10California, Nevada, Oregon, Washington4
798.02Arizona, New Mexico, Oklahoma, Texas4
822.11Illinois, Indiana, Michigan, Ohio, Wisconsin5
829.21Iowa, Kansas, Minnesota, Missouri, North Dakota, Nebraska, South Dakota7
832.93District of Columbia, Delaware, Maryland, New Jersey, New York, Pennsylvania6
881.94Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, West Virginia12

Forty-nine contiguous areas. Rural E2402 RR is $1,504.41 in each of them. July and October match. 2 4

The earlier VEMERIX public-price benchmark reports the broader 53-area pump range, including noncontiguous areas. The median of those non-rural cells is $829.21. This report adds ZIP-level selection and the quarter-to-quarter membership change, which a national range cannot resolve. 15

A6550

Contiguous rural A6550 is $33.70 in all 49 areas. The non-rural row has seven amounts. Six of them follow the pump groups. The seventh, $31.35, merges two pump groups: the $798.02 group and the $881.94 group. Sixteen areas share $31.35.

A6550, non-ruralCountAreas, relative to the pump table
31.085Same areas as pump $752.89
31.314Same areas as pump $792.10
31.3516The $798.02 areas plus the $881.94 areas
31.676Same areas as pump $748.28
31.766Same areas as pump $832.93
31.787Same areas as pump $829.21
31.925Same areas as pump $822.11

Rural A6550 is $33.70 in all 49 contiguous areas. 2 4

A7000 NU

The canister has a different pattern. Contiguous non-rural A7000 NU runs from $9.83 to $10.93 in nine amounts. Contiguous rural A7000 NU varies from $10.23 to $11.58 in 13 amounts. Because the rural pump and the rural dressing are fixed, a one-each rural sum of the three cells runs only from $1,548.34 to $1,549.69. The $1.35 spread is the canister.

A7000 NU, non-ruralCountAreas, relative to the pump table
9.836Same areas as pump $832.93
10.096Same areas as pump $748.28
10.374Same areas as pump $792.10
10.444Illinois, Minnesota, Virginia, West Virginia
10.5010The $881.94 pump areas except Virginia and West Virginia
10.534Same areas as pump $798.02
10.546The $829.21 pump areas except Minnesota
10.574Indiana, Michigan, Ohio, Wisconsin
10.935Same areas as pump $752.89

Nine non-rural canister amounts. July and October match. 2 4

Virginia and West Virginia share the pump’s $881.94 with Alabama and the other southern areas. They share the canister’s $10.44 with Illinois and Minnesota. Alabama’s non-rural canister is $10.50. A quote that scales the Virginia canister off the shared pump step uses $10.50 where the file prints $10.44. The miss is six cents on one canister, and it is the same miss in West Virginia. The pump groups are the wrong index for the canister.

Illinois shares the $822.11 pump with Indiana, Michigan, Ohio, and Wisconsin, and its non-rural canister is $10.44 against their $10.57. Illinois’s rural canister is also $10.44, so the rural and non-rural Illinois quotes share the canister while the pump moves from $822.11 to $1,504.41. Minnesota shares the $829.21 pump with Iowa and prints $10.44 on both canister columns. Iowa’s non-rural canister is $10.54.

West Virginia is the case that shows up in the quarter change below. Rural and non-rural A7000 NU are both $10.44, so a ZIP that leaves the West Virginia rural list keeps the canister and loses the rural pump.

The sum of one of each non-rural cell runs from $790.04 to $923.79. The low sum is the six areas at $748.28, $31.67, and $10.09. The high sum is the ten $881.94 areas whose canister is $10.50. Virginia and West Virginia sum to $923.73 because their canister is $10.44. Illinois sums to $864.47, against $864.60 for the other states at the $822.11 pump. Minnesota sums to $871.43, against $871.53 for the other states at the $829.21 pump. Each area contributes its own three-cell comparison; actual treatment quantities remain unspecified.

Alaska, Hawaii, Puerto Rico, and the Virgin Islands

AreaE2402 RR non-ruralE2402 RR rural columnA6550 non-ruralA7000 NU non-ruralOne of each, non-rural
Alaska1,517.020.0033.709.241,559.96
Hawaii1,517.020.0033.709.901,560.62
Virgin Islands1,517.020.0033.7010.231,560.95
Puerto Rico1,727.820.0037.5412.421,777.78

The rural column is the layout zero DMEREAD describes for non-continental areas. The one-each sum uses the non-rural cells. 2 10

ZIP 96701 is on the Honolulu former-CBA list. Its cells are $928.17, $30.24, and $9.24, in the worksheet. The Hawaii line in the table is the cell for a Hawaii ZIP on neither list. 1 2

Former-CBA amounts can leave the state range

On a former-CBA hit the fee-file canister row is A7000 NU KG. For ZIP 10001 that cell is $9.81, against the New York A7000 NU cells of $9.83 non-rural and $10.23 rural. 1 2

Across 130 former-CBA columns, all filled and all positive on these three rows, E2402 RR runs from $577.81 to $1,078.04, in 91 distinct amounts. The $577.81 minimum is printed for Bridgeport, CT, and for Hartford, CT. Both sit below every contiguous non-rural pump fee. That contiguous minimum is $748.28. The maximum, Orlando, FL, at $1,078.04, sits above every contiguous non-rural pump fee, whose maximum is $881.94, and $426.37 below the contiguous rural pump cell of $1,504.41. Some former-CBA pump fees sit above the contiguous non-rural band. All 130 values are unchanged in October. 1 2 5

A6550 across the same 130 columns runs from $27.40, Miami, FL, to $33.14, New Haven, CT, in 50 distinct amounts. A7000 NU KG runs from $9.05, Miami, to $11.69, in 66 distinct amounts. The $11.69 canister is printed for Las Vegas, NV, Phoenix, AZ, and Tucson, AZ. Those three columns share the dressing too, at $32.60, and their pumps differ: Las Vegas $840.90, Phoenix $657.87, Tucson $641.59. The $11.69 canister is above the highest contiguous A7000 NU rural cell, $11.58, and above the highest contiguous non-rural NU cell, $10.93. It is a NU KG amount. The KE rural amount, up to $12.43, is a different row. 1 2

Orlando, the highest pump, prints A6550 at $27.94 and A7000 NU KG at $9.18. New Haven, the highest dressing at $33.14, prints the pump at $711.03, still below the contiguous non-rural minimum, and the canister at $10.78. Hartford matches Bridgeport’s pump but has different supplies: dressing $30.94 and canister $9.63, against Bridgeport’s $30.81 and $9.52. ZIP 06404 is Bridgeport. A Connecticut ZIP on neither list uses the state non-rural cells, $748.28, $31.67, and $10.09. 1 2

The nine New York former-CBA columns are:

Former-CBA columnE2402 RRA6550A7000 NU KGOne of each
Bronx, NY652.5631.469.81693.83
Port Chester, NY840.9031.799.35882.04
Poughkeepsie, NY842.2531.959.41883.61
Nassau County, NY862.4031.309.35903.05
Suffolk County, NY862.4031.309.41903.11
Rochester, NY866.7332.109.63908.46
Albany, NY868.0232.029.41909.45
Syracuse, NY876.3631.899.46917.71
Buffalo, NY876.3632.369.61918.33

October prints the same nine columns. Nassau and Suffolk share the pump and the dressing. Their canisters differ by $0.06. Buffalo and Syracuse share the pump but have different supplies. The New York state non-rural pump, $832.93, sits between Bronx and Port Chester. The New York rural pump, $1,504.41, sits above all nine. 1 2 5

Miami’s column is the supply minimum and a high pump: E2402 RR $1,052.81, A6550 $27.40, A7000 NU KG $9.05, one of each $1,089.26. The worked Miami rows in this article start at ZIP 33002, which the October and July ZIP files both label Miami, FL. ZIP 00041 is also labeled Miami and was left with the other sub-00501 values, out of the scenarios. 1 5

October keeps these fees and moves four ZIPs

Four rural-list memberships change between quarter 3 and quarter 4 while the fee cells stay fixed. ZIPs 25003, 54488, and 71404 are rural in quarter 3 and on neither the quarter 4 rural list nor the former-CBA list. ZIP 77352 is the reverse. For 25003, E2402 RR changes from the West Virginia rural amount $1,504.41 to the West Virginia non-rural amount $881.94. A6550 changes from $33.70 to $31.35. A7000 NU stays $10.44. 2 3 4 5

Four ZIPs change rural-list membership, and the E2402 RR cell moves with the list
Quarter 3 columnQuarter 4 column
25003 WVQuarter 3 column: 1,504.411,504.41Quarter 4 column: 881.94881.9454488 WIQuarter 3 column: 1,504.411,504.41Quarter 4 column: 822.11822.1171404 LAQuarter 3 column: 1,504.411,504.41Quarter 4 column: 881.94881.9477352 TXQuarter 3 column: 798.02798.02Quarter 4 column: 1,504.411,504.41
View chart data
CategoryQuarter 3 columnQuarter 4 column
25003 WV1504.41881.94
54488 WI1504.41822.11
71404 LA1504.41881.94
77352 TX798.021504.41

ZIP 25003 uses the West Virginia rural cell $1,504.41 in quarter 3 and the West Virginia non-rural cell $881.94 in quarter 4. The October fee cells for E2402 RR match July. The West Virginia canister stays $10.44.

Source: CMS DME rural ZIP files for 2026 quarter 3 (DME26-C) and quarter 4 (DME26-D), with E2402 RR from July 2026 state fee table and October 2026 state fee table — VEMERIX analysis, accessed 4 October 2026. https://www.cms.gov/files/zip/dme26-c.zip and https://www.cms.gov/files/zip/dme26-d.zip

Four ZIPs change rural-list membership, and the E2402 RR cell moves with the list. ZIP 25003 goes from $1,504.41 to $881.94. The October fee table matches July.

The independent comparison covered 814 geographic fee cells: four state-file rows across 106 rural/non-rural columns, plus three rows across 130 former-CBA columns. All matched between July and October. The quarter-4 rural file, however, changes membership. 2 4 5

CMS's quarterly update, MM14619, is effective 1 October 2026, with a contractor implementation date of 5 October. Its six-code list of newly added fee amounts includes E2403 and A6614. The direct file comparison, rather than an inference from that selected list, establishes the unchanged NPWT amounts. Use the effective quarter for the benchmark and confirm contractor processing questions with the MAC. 13

State rural-ZIP counts move with the four ZIPs and only with them: West Virginia 451 to 450, Wisconsin 446 to 445, Louisiana 212 to 211, and Texas 828 to 829. National counts go from 15,909 to 15,907, which is three ZIPs off the list and one ZIP onto it. 3 5

ZIPQuarter 3 columnQuarter 4 columnE2402 RRA6550A7000 NUOne of each
25003, West VirginiaRuralNon-rural1,504.41, then 881.9433.70, then 31.3510.44, then 10.441,548.55, then 923.73
54488, WisconsinRuralNon-rural1,504.41, then 822.1133.70, then 31.9210.98, then 10.571,549.09, then 864.60
71404, LouisianaRuralNon-rural1,504.41, then 881.9433.70, then 31.3511.58, then 10.501,549.69, then 923.79
77352, TexasNon-ruralRural798.02, then 1,504.4131.35, then 33.7010.53, then 11.20839.90, then 1,549.31

None of the four ZIPs is on the former-CBA list in July or October. The unchanged state fee cells are selected differently because rural membership changes. 2 3 5

The one-each drop for ZIP 25003 is $624.82, of which $622.47 is the pump and $2.35 is the dressing. The canister contributes $0.00 because West Virginia’s two canister cells match. ZIP 54488 drops $684.49, of which $682.30 is the pump, $1.78 is the dressing, and $0.41 is the canister, $10.98 to $10.57. ZIP 71404 drops $625.90: pump $622.47, dressing $2.35, canister $1.08, from the rural $11.58 to the non-rural $10.50. ZIP 77352 moves the other way, up $709.41, of which $706.39 is the pump. A quarter change that leaves the NPWT fee table unchanged can still move the illustrative one-unit benchmark by several hundred dollars when the rural list moves.

October also adds two external-ocular-pump rows, a different device category. E2403 RR, “Ext oculr neg pres pump,” has New York non-rural $1,352.58, ceiling $1,352.58, floor $1,149.69, and New York rural $0.00. A6614 NU, “Sup ext oculr neg pres pump,” has New York non-rural $167.99, ceiling $167.99, floor $142.79, and New York rural $0.00. Neither row is in the July file. 4 13 The short descriptions are the fee file’s labels. A wound-pump quote that starts from E2402, “Neg press wound therapy pump,” stays on the E2402 row. E2403’s New York non-rural cell is $519.65 above the New York non-rural E2402 cell and $151.83 below the New York rural E2402 cell. Its device description and populated ceiling distinguish it from the NPWT row.

An exact HCPCS match for A9272, 97605, 97606, 97607, and 97608 returns no row in the July table of 3,531 data rows. The same five codes are absent from the October rows parsed for this comparison. DMEREAD limits the HCPCS column to “current year active codes subject to DMEPOS fee schedule payment rules if covered.” 2 10 That file's scope is limited to its payment class. For disposable systems, consult the applicable benefit and coding policy rather than using a missing DMEPOS row as a market-usage statistic.

One-unit worksheets

For ZIP 10001 the cells to copy are Bronx $652.56, $31.46, and $9.81 in both quarters. For ZIP 25003 the pump cell is $1,504.41 in quarter 3 and $881.94 in quarter 4, with the canister at $10.44 in both. 1 2 5

Use the paste order on the ZIP, then read one row.

ZIPDate-of-service quarterList that winsE2402 RRA6550Canister rowOne of each
10001Quarter 3 or 4Bronx former CBA652.5631.46NU KG 9.81693.83
12207Quarter 3 or 4Albany former CBA868.0232.02NU KG 9.41909.45
06404Quarter 3 or 4Bridgeport former CBA577.8130.81NU KG 9.52618.14
32102Quarter 3 or 4Orlando former CBA1,078.0427.94NU KG 9.181,115.16
33002Quarter 3 or 4Miami former CBA1,052.8127.40NU KG 9.051,089.26
96701Quarter 3 or 4Honolulu former CBA928.1730.24NU KG 9.24967.65
10985Quarter 3 or 4New York rural1,504.4133.70NU 10.231,548.34
13601 or 14850, New York addressQuarter 3 or 4Neither list, New York non-rural832.9331.76NU 9.83874.52
25003Quarter 3West Virginia rural1,504.4133.70NU 10.441,548.55
25003Quarter 4West Virginia non-rural881.9431.35NU 10.44923.73
54488Quarter 3Wisconsin rural1,504.4133.70NU 10.981,549.09
54488Quarter 4Wisconsin non-rural822.1131.92NU 10.57864.60
71404Quarter 3Louisiana rural1,504.4133.70NU 11.581,549.69
71404Quarter 4Louisiana non-rural881.9431.35NU 10.50923.79
77352Quarter 3Texas non-rural798.0231.35NU 10.53839.90
77352Quarter 4Texas rural1,504.4133.70NU 11.201,549.31

Each sum combines one pump rental-month fee cell, one dressing set and one canister solely to illustrate the lookup. Clinical quantities and treatment duration are outside the calculation. The canister is the specified NU or NU KG row. 1 2 3 4 5

For the Bronx pump, applying the general capped-rental reduction gives $652.56 × 75% = $489.42 from month 4, subject to the applicable coverage and billing rules. This is derived arithmetic. The dressing and canister remain separate per-unit rows at $31.46 and $9.81 in the selected former-CBA column. Actual quantities and continued eligibility still need verification. 9 6

The worked examples assume the listed ZIP is the correct address ZIP for pricing and use the standard fee-file branch. Travel, place-of-service and other special claim circumstances were not modeled. Establish those facts and any required modifiers before using the result operationally.

What a distributor should verify before using the benchmark

For an October 2026 date of service at ZIP 10001, copy Bronx $652.56, $31.46, and $9.81. The New York non-rural cells, the New York rural cells, the KE non-rural $0.00, and E2403 are other rows in the same files. 1 2 4

Run the three-step order from the list section on the next ZIP. Re-check 25003, 54488, 71404, and 77352 when the quarter changes. Those four change list while the fee cells stay put. On a contiguous NU quote, the KE row is the wrong canister line: $0.00 in the non-rural column, and a different positive amount in the rural column.

The VEMERIX Medical Vacuum NPWT Pump page displays the Chinese NMPA registration Lu Mech Reg. 20182140303. That registration concerns the stated product and jurisdiction. The Medicare fee files contain no product-specific assignment of that pump to E2402. Article A52511 requires written PDAC coding verification and publication on the appropriate Product Classification List for products billed under E2402. This review establishes no such listing for the VEMERIX model. 16 6

For a US distribution evaluation, request the exact manufacturer/model, applicable US market-authorization evidence and current coding documentation. Match those records to the physical product and its configuration. A category-level reimbursement benchmark is useful commercial context only after those market-access and coding questions have been resolved. To obtain VEMERIX's available specifications and jurisdiction-specific registration documents, use the technical-document enquiry; make the target country and intended channel explicit.

Two earlier VEMERIX reports bound what this worksheet repeats. The public price benchmarks for 2026 already print the July ranges and already say to pick the applicable schedule. The hospital total-cost model already prints the New York Medicaid examples. The pressure-range guide is the piece that takes up the pump’s indicated pressure window. Actual dressing and canister quantities, continued coverage and medical necessity require the applicable LCD and policy article. The one-unit sums deliberately avoid estimating those quantities.

Sources

  1. Centers for Medicare & Medicaid Services, July 2026 former CBA fee schedule and former CBA ZIP code file, inside DME26-C. Columns HCPCS, Mod, Mod2, Mod3, CATG, and 130 CBA names on the fee file. ZIP columns CBA State, CBA ZIP Code, CBA Name Short, CBA Name, and Year/Qtr, coded 202603. Rows for E2402 RR, A6550, and A7000 NU KG. Accessed 4 October 2026.
  2. Centers for Medicare & Medicaid Services, July 2026 state fee table, July 2026 DMEPOS fee schedule, inside DME26-C. Rows E2402 RR, A6550 with both modifiers blank, A7000 NU, and A7000 NU KE. Contiguous columns Alabama through Wyoming, including the District of Columbia, and noncontiguous columns for Alaska, Hawaii, Puerto Rico, and the Virgin Islands. Accessed 4 October 2026.
  3. Centers for Medicare & Medicaid Services, DME Rural Zip Code Quarter 3 2026, inside DME26-C. Columns STATE, DMEPOS RURAL ZIP CODE, and YEAR/QTR, coded 202603. Accessed 4 October 2026.
  4. Centers for Medicare & Medicaid Services, October 2026 state fee table, October 2026 DMEPOS fee schedule, inside DME26-D. The four July NPWT rows, plus E2403 RR and A6614 NU. Accessed 4 October 2026.
  5. Centers for Medicare & Medicaid Services, October 2026 former CBA fee schedule, October 2026 former CBA ZIP code file, and DME Rural Zip Code Quarter 4 2026, inside DME26-D. Former-CBA Year/Qtr coded 202604. Rural YEAR/QTR coded 202604. Accessed 4 October 2026.
  6. Medicare Administrative Contractors, Negative Pressure Wound Therapy Pumps — Policy Article A52511. Revision effective 15 August 2021; current document accessed 4 October 2026. Coding verification, benefit scope and policy-specific documentation. Read with the associated LCD and current MAC instructions.
  7. Centers for Medicare & Medicaid Services, DMEPOS Fee Schedule Files. File list including DME26-C (July 2026) and DME26-D (October 2026). Page last modified 12/17/2024. Accessed 4 October 2026.
  8. Centers for Medicare & Medicaid Services, Payment Policies for DMEPOS Items and Services. Opening payment paragraph. Page last modified 28 July 2026. Accessed 4 October 2026.
  9. Centers for Medicare & Medicaid Services, DMEBACK 2026, inside the July 2026 DMEPOS public use file, DME26-C. Opening payment paragraph, capped-rental class, national ceiling and floor for CBP-adjusted fees, eight-region SPA description, and the 1 January 2024 paragraphs. Accessed 4 October 2026.
  10. Centers for Medicare & Medicaid Services, DMEREAD 2026, inside the July 2026 DMEPOS public use file, DME26-C. File contents, background, file organization, rural ZIP definition, ceiling and floor notes, non-continental rural-column note, and Attachment A-1 modifier and jurisdiction lines. Accessed 4 October 2026.
  11. VEMERIX, NPWT pump hospital price and total cost of therapy. New York Medicaid examples as printed in that report. The Medicaid schedule was not re-audited for this article. Accessed 4 October 2026.
  12. Centers for Medicare & Medicaid Services, DMEPOS Competitive Bidding. Temporary Gap Period. Page last modified 6 April 2026. Accessed 4 October 2026.
  13. Centers for Medicare & Medicaid Services, MLN Matters MM14619, DMEPOS Fee Schedule: October 2026 Quarterly Update. Effective 1 October 2026, implemented 5 October 2026. Added codes and new fee schedule amounts. Accessed 4 October 2026.
  14. Centers for Medicare & Medicaid Services, Medicare Claims Processing Manual, Chapter 36, Competitive Bidding. Posted PDF Rev. 11427, 05-20-22. Section 50.2 Table 1, section revision Rev. 1544, 06-26-08. Accessed 4 October 2026.
  15. VEMERIX, Public price benchmarks for single-use consumables, 2026. Medicare NPWT section, including the July 2026 ranges, Aiken County, and Albuquerque. Accessed 4 October 2026.
  16. VEMERIX, Medical Vacuum NPWT Pump. Specification block, NMPA registration Lu Mech Reg. 20182140303. Accessed 4 October 2026.

Talk to VEMERIX

VEMERIX is the international brand of Weihai Medison Medical Equipment Co., Ltd., positioned as a Minimally Invasive Surgery Total Solution Platform serving urology, vascular surgery and perioperative care.