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See a sample rate comparisonHCPCS K0065 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.
Spoke protectors, 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 K0065 |
National average reimbursement for HCPCS K0065 by major payers:
$40.53
$32.11
$33.51
$68.75
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HCPCS K0065
5 of 25 sample ratesHigher to lower in this preview
Ujuka Iloabuchi
Gwinnett Obgyn Associates Of Georgia LLC
$70.12Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$30.68Published rateBrooks County Hospital
$21.67Published rateSmith Of Georgia, Smith Northview Hospitalists
Smith Of Georgia
$4.19Published rateBacon County Health Services, Inc, Bacon County Rural Health Clinic
Bacon County Health Services Inc
$2.76Published rate
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See a sample payer proposalHCPCS K0065 vs. Other Wheelchairs, Components, and Accessories Codes
The HCPCS K0065 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 K0065 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 |
|---|---|---|
| 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 |
| K0069-HCPCS | Low | Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K0065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K0065 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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