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See a sample rate comparisonHCPCS K0855 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more
| Key Fact | Detail |
|---|---|
| Service Type | Durable medical equipment (DME) Medicare administrative contractors (MACs) Wheelchairs, Power Operated |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for K0855 |
National average reimbursement for HCPCS K0855 by major payers:
$13,343.02
$5,913.17
$8,372.56
$19,586.44
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HCPCS K0855
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$20,057.11Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$7,672.77Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$3,008.57Published rateAnn Steck
Toledo Hospital
$844.61Published rateChristopher Raio
St Joseph Hospital
$492.31Published rate
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See a sample payer proposalHCPCS K0855 vs. Other Wheelchairs, Power Operated Codes
The HCPCS K0855 code is part of the Durable medical equipment (DME) Medicare administrative contractors (MACs) services used for Wheelchairs, Power Operated. 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 K0855 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 |
|---|---|---|
| K0854-HCPCS | High | Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more |
| K0855-HCPCS | High | Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more |
| K0856-HCPCS | High | Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K0855. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K0855 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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