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See a sample rate comparisonHCPCS E1226 Fee Schedule
Last Verified: October 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.
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
| Key Fact | Detail |
|---|---|
| Service Type | Durable Medical Equipment Other Wheelchairs and Accessories |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $465.63 median of the 6 states in the free preview · View Medicaid rates for E1226 |
National average reimbursement for HCPCS E1226 by major payers:
$271.22
$328.73
$293.90
$561.47
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HCPCS E1226
5 of 25 sample ratesHigher to lower in this preview
Emory Healthcare
Emory University
$903.04Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$515.64Published ratePatrick Reidy
Florida Gulf Coast Ear, Nose And Throat, LLC
$278.28Published rateEmory Healthcare
$230.55Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$18.28Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS E1226 vs. Other Other Wheelchairs and Accessories Codes
The HCPCS E1226 code is part of the Durable Medical Equipment services used for Other Wheelchairs and 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 E1226 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 |
|---|---|---|
| E1225-HCPCS | Moderate | Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
| E1226-HCPCS | Moderate | Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
| E1227-HCPCS | Moderate | Special height arms for wheelchair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1226. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1226 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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