E1221 HCPCS code: Wheelchair with fixed arm, footrests
E1221 is the HCPCS Level II code for wheelchair with fixed arm, footrests. The 2026 Medicare DMEPOS fee schedule pays $57.56 to $87.75 (RR, rental (monthly)) 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. Its average fee ranks 7 of 24 E12 codes billed RR (family range $16.56–$316.95).
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 36 — DMEPOS: capped rental item |
| BETOS category | D1D — Wheelchairs |
| Added | 1986-01-01 |
| Last action effective | 1990-01-01 |
2026 Medicare DMEPOS fee schedule for E1221
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $57.56 | $87.75 | $67.72 | $57.56 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $68.41 | — |
| AL | RR | $67.72 | — |
| AR | RR | $61.61 | — |
| AZ | RR | $67.72 | — |
| CA | RR | $67.72 | — |
| CO | RR | $67.72 | — |
| CT | RR | $57.56 | — |
| DC | RR | $67.72 | — |
| DE | RR | $67.72 | — |
| FL | RR | $57.56 | — |
| GA | RR | $67.72 | — |
| HI | RR | $73.16 | — |
| IA | RR | $67.72 | — |
| ID | RR | $57.56 | — |
| IL | RR | $67.72 | — |
| IN | RR | $57.56 | — |
| KS | RR | $58.94 | — |
| KY | RR | $57.56 | — |
| LA | RR | $57.56 | — |
| MA | RR | $67.72 | — |
| MD | RR | $67.72 | — |
| ME | RR | $67.71 | — |
| MI | RR | $60.74 | — |
| MN | RR | $57.56 | — |
| MO | RR | $57.56 | — |
| MS | RR | $67.72 | — |
| MT | RR | $67.72 | — |
| NC | RR | $57.56 | — |
| ND | RR | $67.72 | — |
| NE | RR | $61.02 | — |
| NH | RR | $65.22 | — |
| NJ | RR | $59.74 | — |
| NM | RR | $57.56 | — |
| NV | RR | $67.72 | — |
| NY | RR | $67.72 | — |
| OH | RR | $67.72 | — |
| OK | RR | $57.56 | — |
| OR | RR | $67.72 | — |
| PA | RR | $57.56 | — |
| PR | RR | $87.75 | — |
| RI | RR | $57.56 | — |
| SC | RR | $67.72 | — |
| SD | RR | $67.72 | — |
| TN | RR | $59.67 | — |
| TX | RR | $67.72 | — |
| UT | RR | $61.49 | — |
| VA | RR | $67.72 | — |
| VI | RR | $67.72 | — |
| VT | RR | $67.72 | — |
| WA | RR | $58.92 | — |
| WI | RR | $67.72 | — |
| WV | RR | $67.37 | — |
| WY | RR | $67.72 | — |
How the E1221 fee compares
| Measure | Value |
|---|---|
| Rank among 24 E12 codes billed RR (lowest = 1) | 7 |
| Family fee range (average of state fees) | $16.56–$316.95 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
What changed for E1221
- 2026-01-01: Average state fee (RR) rose 2.0%: $63.28 to $64.54
- 1986-01-01: E1221 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 E1221?
E1221 is the HCPCS Level II code for wheelchair with fixed arm, footrests. Short descriptor: "Wheelchair spec size w foot".
How much does Medicare pay for E1221?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $57.56–$87.75. Rural fees can be higher.
Does Medicare cover E1221?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for E1221 change in 2026?
The average non-rural state fee for RR moved from $63.28 in 2025 to $64.54 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E1221 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related E12 codes
- E1200 — Amputee wheelchair, fixed full length arms, swing away detachable footrest ($105.40–$179.59)
- E1220 — Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
- E1222 — Wheelchair with fixed arm, elevating legrests ($82.09–$129.73)
- E1223 — Wheelchair with detachable arms, footrests ($89.66–$122.59)
- E1224 — Wheelchair with detachable arms, elevating legrests ($98.31–$139.00)
- E1225 — Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each ($43.15–$70.60)
- E1226 — Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each ($41.94–$1,539.67)
- E1227 — Special height arms for wheelchair ($17.79–$474.54)
- E1228 — Special back height for wheelchair ($33.95–$41.50)
- E1229 — Wheelchair, pediatric size, not otherwise specified
- E1230 — Power operated vehicle (three or four wheel nonhighway) specify brand name and model number ($269.48–$3,830.63)
- E1231 — Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
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Next steps
- Run a reimbursement report for a device billed under E1221
- Watch E1221 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E1221
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.