HCPCS E2226 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Durable Medical Equipment • Manual Wheelchair Accessories |
| Complexity Level | Low |
National average reimbursement for HCPCS E2226 by major payers:
$30.26
$27.28
$25.56
$55.69
| 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 E2226 | ||||||
United | E2226 | $35.86 | 1568410264 - TIFT REGIONAL HEALTH SYSTEM, INC., SOUTHWELL MEDICAL | 453072990 - (GA) TIFT REGIONAL HEALTH SYSTEM INC | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $18.50 | 1194779702 - JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC. | 580566121 - JOHN D ARCHBOLD MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $18.70 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | E2226 | $78.15 | 1598964082 - EMORY HEALTHCARE | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $2.46 | 1225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | E2226 | $24.65 | 1700830247 - HOSPITAL AUTHORITY OF MITCHELL COUNTY, MITCHELL COUNTY HOSPITAL | 586001307 - (GA) HOSPITAL AUTHORITY OF MITCHELL COUNTY | GA | Critical Access Hospital (282NC0060X) |
United | E2226 | $24.65 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | E2226 | $3.98 | 1487721718 - VICTORIA LEWIS-HOLLAND | 586011888 | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $18.50 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 273100894 | GA | Critical Access Hospital (282NC0060X) |
United | E2226 | $30.35 | 1033168257 - DUBLIN VAMC | 582080668 - (GA) DUBLIN VAMC | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $78.15 | 1396923710 - EMORY UNIVERSITY HOSPITAL | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $24.45 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 582155150 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $29.47 | 1487684122 - UNION COUNTY HOSPITAL AUTHORITY, UNION GENERAL HOSPITAL | 586025393 - (GA) UNION COUNTY HOSPITAL AUTHORITY | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $23.59 | 1649646472 - LEIGH TAYLOR | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | E2226 | $2.46 | 1316938459 - NAVICENT HEALTH OCONEE, LLC, NAVICENT HEALTH BALDWIN | 582359398 - NAVICENT HEALTH OCONEE LLC | 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 E2226 vs. Other Manual Wheelchair Accessories Codes
The HCPCS E2226 code is part of the Durable Medical Equipment services used for Manual 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 E2226 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 |
|---|---|---|
| E2225-HCPCS | Low | Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
| E2226-HCPCS | Low | Manual wheelchair accessory, caster fork, any size, replacement only, each |
| E2227-HCPCS | High | Manual wheelchair accessory, gear reduction drive wheel, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E2226. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E2226 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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