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See a sample rate comparisonHCPCS K0056 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.
Seat height less than 17 inch or equal to or greater than 21 inch for a high strength, lightweight, or ultralightweight wheelchair
| 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 K0056 |
National average reimbursement for HCPCS K0056 by major payers:
$70.21
$67.32
$58.36
$136.03
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HCPCS K0056
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$192.38Published rateAugusta Vamc
$76.08Published ratePiedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$61.29Published rateKamran Rajaee
$43.77Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$3.89Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS K0056 vs. Other Wheelchairs, Components, and Accessories Codes
The HCPCS K0056 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 K0056 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 |
|---|---|---|
| K0053-HCPCS | Low | Elevating footrests, articulating (telescoping), each |
| K0056-HCPCS | Low | Seat height less than 17 inch or equal to or greater than 21 inch for a high strength, lightweight, or ultralightweight wheelchair |
| K0065-HCPCS | Low | Spoke protectors, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K0056. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K0056 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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