E1226 HCPCS code: Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each

E1226 is the HCPCS Level II code for wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each. The 2026 Medicare DMEPOS fee schedule pays $419.38 to $1,024.59 (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 14% from 2022 to 2024 (21,240 to 24,173 services). In 2024, 801 suppliers billed Medicare for E1226 (rentals), serving 8,989 beneficiaries; California, New Jersey, New York accounted for 34% of services. Its average fee ranks 4 of 6 E12 codes billed NU (family range $139.52–$3,060.71).

Code details

2026 Medicare DMEPOS fee schedule for E1226

How the E1226 fee compares

Who bills E1226 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for E1226, 2022–2024

States with the most E1226 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52504: Wheelchair Options/Accessories - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

What changed for E1226

• 2026-01-01: Average state fee (NU) rose 2.3%: $606.58 to $620.24
• 2026-01-01: Average state fee (RR) rose 2.2%: $62.02 to $63.41
• 2026-01-01: Average state fee (UE) rose 2.3%: $455.02 to $465.26
• 1986-01-01: E1226 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 E1226?

E1226 is the HCPCS Level II code for wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each. Short descriptor: "Manual fully reclining back".

How much does Medicare pay for E1226?

Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $419.38–$1,024.59; NU (new equipment, purchased): $660.99–$1,539.67; RR (rental (monthly)): $41.94–$102.46; RR (rental (monthly)): $68.02–$153.98; UE (used equipment, purchased): $495.68–$1,154.46; UE (used equipment, purchased): $314.53–$768.30. Rural fees can be higher.

Does Medicare cover E1226?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Did the Medicare fee for E1226 change in 2026?

The average non-rural state fee for NU moved from $606.58 in 2025 to $620.24 in 2026 (+2.3%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of E1226 can be billed per day?

1 on DME suppliers; 1 on outpatient hospital claims (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
• E1221 — Wheelchair with fixed arm, footrests ($57.56–$87.75)
• 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)
• 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 E1226
• Watch E1226 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for E1226

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.

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