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See a sample rate comparisonHCPCS E0197 Fee Schedule
Last Verified: September 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.
Air pressure pad for mattress, standard mattress length and width
| Key Fact | Detail |
|---|---|
| Service Type | Durable Medical Equipment Pressure Mattresses, Pads, and Other Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for E0197 |
National average reimbursement for HCPCS E0197 by major payers:
$152.89
$106.35
$135.47
$264.14
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HCPCS E0197
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$365.89Published rateBrooks County Hospital
$122.41Published rateChristopher Raio
St Francis Hospital
$83.20Published rateHamilton Medical Center, Inc.
Hamilton Medical Center Inc
$20.11Published rateSt. Francis Radiologists, LLC
$11.60Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS E0197 vs. Other Pressure Mattresses, Pads, and Other Supplies Codes
The HCPCS E0197 code is part of the Durable Medical Equipment services used for Pressure Mattresses, Pads, and Other 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 E0197 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 |
|---|---|---|
| E0196-HCPCS | Low | Gel pressure mattress |
| E0197-HCPCS | Low | Air pressure pad for mattress, standard mattress length and width |
| E0198-HCPCS | Low | Water pressure pad for mattress, standard mattress length and width |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E0197. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E0197 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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