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See a sample rate comparisonHCPCS E1086 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.
Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests
| Key Fact | Detail |
|---|---|
| Service Type | Durable Medical Equipment Hemi-Wheelchairs |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for E1086 |
National average reimbursement for HCPCS E1086 by major payers:
$414.16
$607.90
$435.85
$895.89
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HCPCS E1086
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$1,334.47Published rateMonroe Hma, LLC, Clearview Regional Medical Center
Monroe Hma LLC
$617.69Published rateDodge County Hospital Authority, Dodge County Hospital
Dodge County Hospital Authority
$529.66Published rateLower Oconee Community Hospital Inc
$368.36Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$46.29Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS E1086 vs. Other Hemi-Wheelchairs Codes
The HCPCS E1086 code is part of the Durable Medical Equipment services used for Hemi-Wheelchairs. 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 E1086 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 |
|---|---|---|
| E1085-HCPCS | Moderate | Hemi-wheelchair, fixed full length arms, swing away detachable footrests |
| E1086-HCPCS | Moderate | Hemi-wheelchair detachable arms desk or full length, swing away detachable footrests |
| E1087-HCPCS | High | High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1086. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1086 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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