E0188 HCPCS code: Synthetic sheepskin pad
E0188 is the HCPCS Level II code for synthetic sheepskin pad. The 2026 Medicare DMEPOS fee schedule pays $28.49 to $54.96 (NU, new equipment, purchased) depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on DME suppliers. Medicare volume rose 21% from 2022 to 2024 (1,459 to 1,764 services). In 2024, 51 suppliers billed Medicare for E0188 (purchases), serving 1,743 beneficiaries; Ohio, Alaska, New York accounted for 58% of services. Its average fee ranks 10 of 34 E01 codes billed NU (family range $13.50–$517.31); rural fees run 9% higher.
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 1986-01-01 |
| Last action effective | 2001-01-01 |
2026 Medicare DMEPOS fee schedule for E0188
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $28.49 | $54.96 | — | — |
| RR | rental (monthly) | $2.85 | $5.50 | — | — |
| UE | used equipment, purchased | $21.37 | $41.22 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $54.96 | — |
| AL | NU | $30.06 | $32.02 |
| AR | NU | $30.06 | $35.67 |
| AZ | NU | $28.49 | $35.67 |
| CA | NU | $31.44 | $35.67 |
| CO | NU | $29.75 | $32.02 |
| CT | NU | $29.48 | $32.02 |
| DC | NU | $30.64 | $35.67 |
| DE | NU | $30.64 | $35.67 |
| FL | NU | $30.06 | $32.02 |
| GA | NU | $30.06 | $35.67 |
| HI | NU | $43.83 | — |
| IA | NU | $32.44 | $34.70 |
| ID | NU | $29.75 | $33.92 |
| IL | NU | $32.51 | $35.67 |
| IN | NU | $32.51 | $35.67 |
| KS | NU | $32.44 | $35.67 |
| KY | NU | $30.06 | $35.67 |
| LA | NU | $30.06 | $35.67 |
| MA | NU | $29.48 | $32.02 |
| MD | NU | $30.64 | $35.67 |
| ME | NU | $29.48 | $32.02 |
| MI | NU | $32.28 | $32.28 |
| MN | NU | $32.44 | $35.26 |
| MO | NU | $32.44 | $35.67 |
| MS | NU | $30.06 | $35.67 |
| MT | NU | $29.75 | $35.67 |
| NC | NU | $30.06 | $35.67 |
| ND | NU | $32.02 | $32.02 |
| NE | NU | $32.02 | $32.02 |
| NH | NU | $29.48 | $32.02 |
| NJ | NU | $30.64 | $35.67 |
| NM | NU | $28.49 | $32.02 |
| NV | NU | $31.44 | $35.67 |
| NY | NU | $30.64 | $32.02 |
| OH | NU | $32.51 | $35.67 |
| OK | NU | $28.49 | $35.67 |
| OR | NU | $31.44 | $35.67 |
| PA | NU | $30.64 | $35.67 |
| PR | NU | $46.47 | — |
| RI | NU | $29.48 | $32.02 |
| SC | NU | $30.06 | $35.67 |
| SD | NU | $32.02 | $32.02 |
| TN | NU | $30.06 | $35.67 |
| TX | NU | $28.49 | $32.02 |
| UT | NU | $29.75 | $34.98 |
| VA | NU | $30.06 | $35.67 |
| VI | NU | $32.95 | — |
| VT | NU | $29.48 | $32.02 |
| WA | NU | $31.44 | $35.67 |
| WI | NU | $32.51 | $35.67 |
| WV | NU | $30.06 | $35.67 |
| WY | NU | $29.75 | $34.59 |
| AK | RR | $5.50 | — |
| AL | RR | $3.01 | $3.56 |
| AR | RR | $3.01 | $3.90 |
| AZ | RR | $2.85 | $3.90 |
| CA | RR | $3.14 | $3.89 |
| CO | RR | $2.98 | $3.56 |
| CT | RR | $2.95 | $3.56 |
| DC | RR | $3.07 | $3.90 |
| DE | RR | $3.07 | $3.90 |
| FL | RR | $3.01 | $3.56 |
| GA | RR | $3.01 | $3.90 |
| HI | RR | $4.38 | — |
| IA | RR | $3.24 | $3.56 |
| ID | RR | $2.98 | $3.56 |
| IL | RR | $3.25 | $3.90 |
| IN | RR | $3.25 | $3.90 |
| KS | RR | $3.24 | $3.90 |
| KY | RR | $3.01 | $3.90 |
| LA | RR | $3.01 | $3.90 |
| MA | RR | $2.95 | $3.56 |
| MD | RR | $3.07 | $3.90 |
| ME | RR | $2.95 | $3.56 |
| MI | RR | $3.25 | $3.56 |
| MN | RR | $3.24 | $3.56 |
| MO | RR | $3.24 | $3.90 |
| MS | RR | $3.01 | $3.90 |
| MT | RR | $2.98 | $3.90 |
| NC | RR | $3.01 | $3.90 |
| ND | RR | $3.24 | $3.56 |
| NE | RR | $3.24 | $3.56 |
| NH | RR | $2.95 | $3.56 |
| NJ | RR | $3.07 | $3.90 |
| NM | RR | $2.85 | $3.56 |
| NV | RR | $3.14 | $3.90 |
| NY | RR | $3.07 | $3.56 |
| OH | RR | $3.25 | $3.90 |
| OK | RR | $2.85 | $3.90 |
| OR | RR | $3.14 | $3.87 |
| PA | RR | $3.07 | $3.90 |
| PR | RR | $4.66 | — |
| RI | RR | $2.95 | $3.56 |
| SC | RR | $3.01 | $3.90 |
| SD | RR | $3.24 | $3.56 |
| TN | RR | $3.01 | $3.90 |
| TX | RR | $2.85 | $3.56 |
| UT | RR | $2.98 | $3.56 |
| VA | RR | $3.01 | $3.90 |
| VI | RR | $4.39 | — |
| VT | RR | $2.95 | $3.56 |
| WA | RR | $3.14 | $3.87 |
| WI | RR | $3.25 | $3.90 |
| WV | RR | $3.01 | $3.90 |
| WY | RR | $2.98 | $3.56 |
| AK | UE | $41.22 | — |
| AL | UE | $22.54 | $24.05 |
| AR | UE | $22.54 | $26.77 |
| AZ | UE | $21.37 | $26.77 |
| CA | UE | $23.59 | $26.77 |
| CO | UE | $22.32 | $24.05 |
| CT | UE | $22.11 | $24.05 |
| DC | UE | $22.98 | $26.77 |
| DE | UE | $22.98 | $26.77 |
| FL | UE | $22.54 | $24.05 |
| GA | UE | $22.54 | $26.77 |
| HI | UE | $32.85 | — |
| IA | UE | $24.33 | $26.03 |
| ID | UE | $22.32 | $25.45 |
| IL | UE | $24.39 | $26.77 |
| IN | UE | $24.39 | $26.77 |
| KS | UE | $24.05 | $24.05 |
| KY | UE | $22.54 | $26.77 |
| LA | UE | $22.54 | $26.77 |
| MA | UE | $22.11 | $24.05 |
| MD | UE | $22.98 | $26.77 |
| ME | UE | $22.11 | $24.05 |
| MI | UE | $24.19 | $24.19 |
| MN | UE | $24.33 | $26.45 |
| MO | UE | $24.33 | $26.77 |
| MS | UE | $22.54 | $26.77 |
| MT | UE | $22.32 | $26.77 |
| NC | UE | $22.54 | $26.77 |
| ND | UE | $24.05 | $24.05 |
| NE | UE | $24.05 | $24.05 |
| NH | UE | $22.11 | $24.05 |
| NJ | UE | $22.98 | $26.77 |
| NM | UE | $21.37 | $24.05 |
| NV | UE | $23.59 | $26.77 |
| NY | UE | $22.98 | $24.05 |
| OH | UE | $24.39 | $26.77 |
| OK | UE | $21.37 | $26.77 |
| OR | UE | $23.59 | $26.77 |
| PA | UE | $22.98 | $26.77 |
| PR | UE | $34.85 | — |
| RI | UE | $22.11 | $24.05 |
| SC | UE | $22.54 | $26.77 |
| SD | UE | $24.05 | $24.05 |
| TN | UE | $22.54 | $26.77 |
| TX | UE | $21.37 | $24.05 |
| UT | UE | $22.32 | $26.23 |
| VA | UE | $22.54 | $26.77 |
| VI | UE | $24.05 | — |
| VT | UE | $22.11 | $24.05 |
| WA | UE | $23.59 | $26.77 |
| WI | UE | $24.39 | $26.77 |
| WV | UE | $22.54 | $26.77 |
| WY | UE | $22.32 | $25.93 |
How the E0188 fee compares
| Measure | Value |
|---|---|
| Rank among 34 E01 codes billed NU (lowest = 1) | 10 |
| Family fee range (average of state fees) | $13.50–$517.31 |
| Rural fee uplift | 8.7% |
Who bills E0188 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 51 |
| Referring clinicians | 223 |
| Medicare beneficiaries | 1,743 |
| States with claims | 18 |
| Share of services in top 3 states (Ohio, Alaska, New York) | 58% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 49 | 1,447 |
| 2023 | 52 | 1,610 |
| 2024 | 51 | 1,743 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E0188, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,459 | 1,447 | $29.24 | $22.88 |
| 2023 | 1,615 | 1,610 | $32.78 | $25.53 |
| 2024 | 1,764 | 1,743 | $35.38 | $27.52 |
States with the most E0188 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Ohio | 490 | $25.83 |
| Alaska | 382 | $40.78 |
| New York | 137 | $18.64 |
| Georgia | 125 | $23.48 |
| Nevada | 118 | $24.63 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Nature of Equipment |
What changed for E0188
- 2026-01-01: Average state fee (NU) rose 2.6%: $30.83 to $31.63
- 2026-01-01: Average state fee (RR) rose 2.6%: $3.11 to $3.19
- 2026-01-01: Average state fee (UE) rose 2.6%: $23.11 to $23.71
- 1986-01-01: E0188 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code E0188?
E0188 is the HCPCS Level II code for synthetic sheepskin pad. Short descriptor: "Synthetic sheepskin pad".
How much does Medicare pay for E0188?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $28.49–$54.96; RR (rental (monthly)): $2.85–$5.50; UE (used equipment, purchased): $21.37–$41.22. Rural fees can be higher.
Does Medicare cover E0188?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E0188 change in 2026?
The average non-rural state fee for NU moved from $30.83 in 2025 to $31.63 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E0188 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related E01 codes
- E0100 — Cane, includes canes of all materials, adjustable or fixed, with tip ($6.11–$48.89)
- E0105 — Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips ($10.74–$86.55)
- E0110 — Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips ($17.71–$141.62)
- E0111 — Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips ($8.81–$80.49)
- E0112 — Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips ($7.97–$63.92)
- E0113 — Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip ($4.00–$55.77)
- E0114 — Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips ($10.38–$88.73)
- E0116 — Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each ($5.58–$44.38)
- E0117 — Crutch, underarm, articulating, spring assisted, each ($27.45–$32.96)
- E0118 — Crutch substitute, lower leg platform, with or without wheels, each
- E0130 — Walker, rigid (pickup), adjustable or fixed height ($5.35–$86.89)
- E0135 — Walker, folding (pickup), adjustable or fixed height ($5.35–$105.44)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under E0188
- Watch E0188 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0188
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.