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See a sample rate comparisonHCPCS E1285 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.
Heavy duty wheelchair, fixed full length arms, swing away detachable footrest
| Key Fact | Detail |
|---|---|
| Service Type | Durable Medical Equipment Heavy Duty and Special Wheelchairs |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for E1285 |
National average reimbursement for HCPCS E1285 by major payers:
$625.26
$742.14
$486.55
$1,210.00
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HCPCS E1285
5 of 25 sample ratesHigher to lower in this preview
Atl Colorectal Surgery
$1,490.60Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$991.46Published rateTanner Medical Center, Inc, Tanner Health System
Tanner Medical Center Inc
$646.79Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$566.53Published rateGood Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital
Good Samaritan Hospital Inc
$43.08Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS E1285 vs. Other Heavy Duty and Special Wheelchairs Codes
The HCPCS E1285 code is part of the Durable Medical Equipment services used for Heavy Duty and Special 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 E1285 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 |
|---|---|---|
| E1280-HCPCS | High | Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests |
| E1285-HCPCS | Moderate | Heavy duty wheelchair, fixed full length arms, swing away detachable footrest |
| E1290-HCPCS | Moderate | Heavy duty wheelchair, detachable arms (desk or full length) swing away detachable footrest |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E1285 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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