E1228 HCPCS code: Special back height for wheelchair

E1228 is the HCPCS Level II code for special back height for wheelchair. The 2026 Medicare DMEPOS fee schedule pays $33.95 to $41.50 (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 3 of 24 E12 codes billed RR (family range $16.56–$316.95).

Code details

2026 Medicare DMEPOS fee schedule for E1228

How the E1228 fee compares

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 E1228

• 2026-01-01: Average state fee (RR) rose 2.0%: $36.62 to $37.35
• 1986-01-01: E1228 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 E1228?

E1228 is the HCPCS Level II code for special back height for wheelchair. Short descriptor: "Wheelchair spec sz spec ht b".

How much does Medicare pay for E1228?

Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $33.95–$41.50. Rural fees can be higher.

Does Medicare cover E1228?

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

Did the Medicare fee for E1228 change in 2026?

The average non-rural state fee for RR moved from $36.62 in 2025 to $37.35 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of E1228 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
• 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)
• 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)
• 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 E1228
• Watch E1228 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for E1228

Sources: CMS HCPCS Level II release October 2026; 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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