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HCPCS E1297 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.

Special wheelchair seat depth, by upholstery
Key FactDetail
Service Type

Durable Medical Equipment

Heavy Duty and Special Wheelchairs

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for E1297

National average reimbursement for HCPCS E1297 by major payers:

bcbs

$89.30

uhc

$72.72

aetna

$76.53

cigna

$169.52

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS E1297.

HCPCS E1297
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $170.41Published rate
  2. Meriwether County Hospital Authority, Warm Springs Medical Center

    Meriwether Healthcare, LLC D/B/A Warm Springs Medical Center

    GACritical Access HospitalNPI 1497756019Tax ID 87-0764535

    $72.91Published rate
  3. Emory Healthcare

    Cardiac Arrhythmia Institute

    GAGeneral Acute Care HospitalNPI 1417157405Tax ID 71-1018941

    $61.97Published rate
  4. Atl Colorectal Surgery

    GAGeneral Acute Care HospitalNPI 1689063554Tax ID 20-5040872

    $18.32Published rate
  5. Christopher Raio

    Good Samaritan Hosptial Medical Center

    NYEmergency Medicine PhysicianNPI 1255478004Tax ID 11-1888924

    $7.46Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS E1297 vs. Other Heavy Duty and Special Wheelchairs Codes

The HCPCS E1297 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 E1297 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.

CodeComplexityDescription
E1296-HCPCSModerateSpecial wheelchair seat height from floor
E1297-HCPCSLowSpecial wheelchair seat depth, by upholstery
E1298-HCPCSModerateSpecial wheelchair seat depth and/or width, by construction

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E1297. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the E1297 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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