Penile contracture device, manual, greater than 3 lbs traction force
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 1 units per day (policy), rationale: Anatomic Consideration
Outpatient hospital: max 1 units per day (policy), rationale: Anatomic Consideration
Medicare pricing for E0201
DMEPOS fee schedule, July 2026 (DME26-C)
NU (purchased, new), inexpensive or routinely purchased (IN): non-rural $146.52 in the contiguous states; $146.52 in AK, HI, PR and VI; ceiling $146.52, floor $124.54
RR (rental), inexpensive or routinely purchased (IN): non-rural $14.65 in the contiguous states; $14.65 in AK, HI, PR and VI; ceiling $14.65, floor $12.45
UE (purchased, used), inexpensive or routinely purchased (IN): non-rural $109.89 in the contiguous states; $109.89 in AK, HI, PR and VI; ceiling $109.89, floor $93.41
Payer policies and prior authorization for E0201
Payer coverage policies that name E0201
E0201 appears in 3 coverage policies from Aetna, Premera Blue Cross.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.