HCPCS E2616 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 • Wheelchair Seat and Back Cushions |
| Complexity Level | Moderate |
National average reimbursement for HCPCS E2616 by major payers:
$468.54
$386.87
$408.22
$683.18
| 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 E2616 | ||||||
United | E2616 | $57.50 | 1720098791 - IRWIN COUNTY HOSPITAL | 586003765 | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $807.95 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | E2616 | $970.13 | 1598964082 - EMORY HEALTHCARE | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $35.04 | 1245201094 - SCREVEN COUNTY HOSPITAL | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | E2616 | $431.33 | 1689736282 - THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY | 586002961 | GA | Rural Acute Care Hospital (282NR1301X) |
United | E2616 | $273.87 | 1194752840 - PATRICK REIDY | 202399514 - FLORIDA GULF COAST EAR, NOSE AND THROAT, LLC | FL | Otolaryngology Physician (207Y00000X) |
United | E2616 | $1257.35 | 1588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $28.61 | 1427055821 - NORTHEAST GEORGIA MEDICAL CENTER, INC. | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $95.62 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $254.24 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $395.57 | 1982658944 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS | 721553462 | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $395.57 | 1912099094 - COLQUITT REGIONAL MEDICAL CENTER | 580607088 - COLQUITT REGIONAL MEDICAL CENTER | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $479.26 | 1043265564 - MONROE HMA, LLC, CLEARVIEW REGIONAL MEDICAL CENTER | 200141568 - (GA) MONROE HMA LLC | GA | General Acute Care Hospital (282N00000X) |
United | E2616 | $431.33 | 1770684284 - THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA, MONROE COUNTY HOSPITAL | 586010602 - (GA) THE HOSPITAL AUTHORITY OF MONROE COUNTY GEORGIA | GA | Critical Access Hospital (282NC0060X) |
United | E2616 | $262.77 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
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 E2616 vs. Other Wheelchair Seat and Back Cushions Codes
The HCPCS E2616 code is part of the Durable Medical Equipment services used for Wheelchair Seat and Back Cushions. 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 E2616 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 |
|---|---|---|
| E2615-HCPCS | Moderate | Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware |
| E2616-HCPCS | Moderate | Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware |
| E2617-HCPCS | High | Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS E2616. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the E2616 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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