E1295 HCPCS code: Heavy duty wheelchair, fixed full length arms, elevating legrest

E1295 is the HCPCS Level II code for heavy duty wheelchair, fixed full length arms, elevating legrest. The 2026 Medicare DMEPOS fee schedule pays $147.14 to $245.71 (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 15 of 24 E12 codes billed RR (family range $16.56–$316.95).

Code details

2026 Medicare DMEPOS fee schedule for E1295

How the E1295 fee compares

NCCI unit limits (MUE)

What changed for E1295

• 2026-01-01: Average state fee (RR) rose 2.0%: $163.24 to $166.50
• 1986-01-01: E1295 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 E1295?

E1295 is the HCPCS Level II code for heavy duty wheelchair, fixed full length arms, elevating legrest. Short descriptor: "Wheelchair heavy duty fixed".

How much does Medicare pay for E1295?

Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $147.14–$245.71. Rural fees can be higher.

Does Medicare cover E1295?

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

Did the Medicare fee for E1295 change in 2026?

The average non-rural state fee for RR moved from $163.24 in 2025 to $166.50 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of E1295 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)
• 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)

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Next steps

• Run a reimbursement report for a device billed under E1295
• Watch E1295 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for E1295

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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