HCPCS E1035 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Durable Medical Equipment • Wheelchair Accessories |
| Common Place of Service | |
| Common Modifiers | |
| Complexity Level | High |
National average reimbursement for HCPCS E1035 by major payers:
$5,298.31
$495.58
$946.81
$8,986.31
| 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 E1035 | ||||||
United | E1035 | $245.80 | 1346209137 - GOOD SAMARITAN HOSPITAL, INC., ST. MARY'S GOOD SAMARITAN HOSPITAL | 261720984 - (GA) GOOD SAMARITAN HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | E1035 | $967.27 | 1689063554 - ATL COLORECTAL SURGERY | 205040872 - (GA) ATL COLORECTAL SURGERY | GA | General Acute Care Hospital (282N00000X) |
United | E1035 | $245.80 | 1235153883 - WILDWOOD SANITARIUM, INCORPORATED, WILDWOOD LIFESTYLE CENTER AND HOSPITAL | 586039864 - (GA) WILDWOOD SANITARIUM INCORPORATED | GA | General Acute Care Hospital (282N00000X) |
United | E1035 | $398.57 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | E1035 | $1309.64 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | E1035 | $1309.64 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | E1035 | $490.56 | 1073638490 - SHARRON ACOSTA M.D.P.A. | 742979530 - SHARRON ACOSTA, M.D., P.A. | TX | Ophthalmology Physician (207W00000X) |
United | E1035 | $371.98 | 1235306648 - ST. FRANCIS RADIOLOGISTS, LLC | 475419443 | GA | General Acute Care Hospital (282N00000X) |
United | E1035 | $371.98 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | E1035 | $368.70 | 1306136551 - UJUKA ILOABUCHI | 582483738 | GA | Women's Hospital (282NW0100X) |
United | E1035 | $1205.67 | 1598964082 - EMORY HEALTHCARE | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E1035 | $398.57 | 1316938459 - NAVICENT HEALTH OCONEE, LLC, NAVICENT HEALTH BALDWIN | 582359398 - NAVICENT HEALTH OCONEE LLC | GA | General Acute Care Hospital (282N00000X) |
United | E1035 | $398.57 | 1710105119 - THE HOSPITAL AUTHORITY OF MILLER COUNTY, MILLER COUNTY HOSPITAL - PRO FEES | 586010601 - THE HOSPITAL AUTHORITY OF MILLER COUNTY | GA | Critical Access Hospital (282NC0060X) |
United | E1035 | $398.57 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 273100894 | GA | Critical Access Hospital (282NC0060X) |
United | E1035 | $368.70 | 1831538743 - JACOB HOLLOWAY | 273818647 | GA | General Acute Care Hospital (282N00000X) |
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 E1035 vs. Other Wheelchair Accessories Codes
The HCPCS E1035 code is part of the Durable Medical Equipment services used for Wheelchair Accessories. 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 E1035 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 |
|---|---|---|
| E1031 | Moderate | Rollabout chair, any and all types with castors 5 inch or greater |
| E1035 | High | Multi-positional patient transfer system, with integrated seat, operated by care giver, patient weight capacity up to and including 300 lbs |
| E1036 | High | Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1035 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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