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See a sample rate comparisonHCPCS K0038 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.
Leg strap, each
| Key Fact | Detail |
|---|---|
| Service Type | Durable medical equipment (DME) Medicare administrative contractors (MACs) Wheelchairs, Components, and Accessories |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for K0038 |
National average reimbursement for HCPCS K0038 by major payers:
$19.88
$16.68
$15.42
$34.24
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HCPCS K0038
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$28.70Published rateProgressive Emergency Physicians PLLC
$15.80Published rateNgmc Barrow LLC, Ngmc Barrow
Gainesville Radiology Group
$14.10Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$1.90Published rateSt. Francis Radiologists, LLC
$1.39Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS K0038 vs. Other Wheelchairs, Components, and Accessories Codes
The HCPCS K0038 code is part of the Durable medical equipment (DME) Medicare administrative contractors (MACs) services used for Wheelchairs, Components, 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 K0038 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 |
|---|---|---|
| K0037-HCPCS | Low | High mount flip-up footrest, each |
| K0038-HCPCS | Low | Leg strap, each |
| K0039-HCPCS | Low | Leg strap, H style, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K0038. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K0038 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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