HCPCS E0116 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 • Walking Aids and Attachments |
| Complexity Level | Low |
National average reimbursement for HCPCS E0116 by major payers:
$20.80
$19.16
$21.07
$42.66
| 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 E0116 | ||||||
United | E0116 | $16.28 | 1588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | 463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | NY | Multi-Specialty Group (193200000X) |
United | E0116 | $21.92 | 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 | E0116 | $11.53 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | E0116 | $12.38 | 1306136551 - UJUKA ILOABUCHI | 582483738 | GA | Women's Hospital (282NW0100X) |
United | E0116 | $12.38 | 1417157405 - EMORY HEALTHCARE | 901116753 | GA | General Acute Care Hospital (282N00000X) |
United | E0116 | $15.32 | 1326028978 - CHATUGE REGIONAL HOSPITAL INC | 582513901 - CHATUGE REGIONAL HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | E0116 | $16.95 | 1588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | 463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | NY | Emergency Medicine Physician (207P00000X) |
United | E0116 | $15.32 | 1326191180 - PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC, MOUNTAIN LAKES MEDICAL CENTER | 202012765 | GA | Critical Access Hospital (282NC0060X) |
United | E0116 | $12.38 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | E0116 | $4.32 | 1801844469 - AUGUSTA VAMC | 582089405 - AUGUSTA VAMC | GA | General Acute Care Hospital (282N00000X) |
United | E0116 | $37.20 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | E0116 | $12.38 | 1508900101 - MICHAEL KOCH | 30450086 - (GA) CHESTATEE PATHOLOGY ASSOCIATES PC | GA | General Acute Care Hospital (282N00000X) |
United | E0116 | $12.76 | 1588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | 463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | NY | Emergency Medicine Physician (207P00000X) |
United | E0116 | $20.87 | 1992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL | 581928247 - (GA) PHOEBE PUTNEY MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | E0116 | $10.65 | 1194752840 - PATRICK REIDY | 202399514 - FLORIDA GULF COAST EAR, NOSE AND THROAT, LLC | FL | Otolaryngology Physician (207Y00000X) |
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 E0116 vs. Other Walking Aids and Attachments Codes
The HCPCS E0116 code is part of the Durable Medical Equipment services used for Walking Aids and Attachments. 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 E0116 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 |
|---|---|---|
| E0114-HCPCS | Low | Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
| E0116-HCPCS | Low | Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each |
| E0117-HCPCS | Low | Crutch, underarm, articulating, spring assisted, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0116. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E0116 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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