E1701 HCPCS code: Replacement cushions for jaw motion rehabilitation system, pkg. of 6
E1701 is the HCPCS Level II code for replacement cushions for jaw motion rehabilitation system, pkg. of 6. The 2026 Medicare DMEPOS fee schedule pays $12.84 to $16.34 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 3 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 34 — DMEPOS: supplies necessary for the effective use of DME |
| BETOS category | D1E — Other durable medical equipment |
| Added | 1993-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for E1701
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $12.84 | $16.34 | $15.11 | $12.84 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $15.30 | — |
| AL | — | $15.11 | — |
| AR | — | $15.11 | — |
| AZ | — | $15.11 | — |
| CA | — | $15.11 | — |
| CO | — | $15.11 | — |
| CT | — | $12.84 | — |
| DC | — | $14.78 | — |
| DE | — | $14.78 | — |
| FL | — | $14.35 | — |
| GA | — | $14.35 | — |
| HI | — | $16.34 | — |
| IA | — | $15.11 | — |
| ID | — | $15.11 | — |
| IL | — | $14.35 | — |
| IN | — | $15.11 | — |
| KS | — | $14.68 | — |
| KY | — | $15.11 | — |
| LA | — | $15.11 | — |
| MA | — | $14.78 | — |
| MD | — | $12.84 | — |
| ME | — | $14.78 | — |
| MI | — | $12.84 | — |
| MN | — | $15.11 | — |
| MO | — | $14.91 | — |
| MS | — | $12.84 | — |
| MT | — | $12.84 | — |
| NC | — | $15.11 | — |
| ND | — | $15.11 | — |
| NE | — | $14.62 | — |
| NH | — | $14.78 | — |
| NJ | — | $14.78 | — |
| NM | — | $15.11 | — |
| NV | — | $15.11 | — |
| NY | — | $15.11 | — |
| OH | — | $15.11 | — |
| OK | — | $15.11 | — |
| OR | — | $15.11 | — |
| PA | — | $14.78 | — |
| PR | — | $16.27 | — |
| RI | — | $14.78 | — |
| SC | — | $15.11 | — |
| SD | — | $15.11 | — |
| TN | — | $15.11 | — |
| TX | — | $14.41 | — |
| UT | — | $12.84 | — |
| VA | — | $14.42 | — |
| VI | — | $15.11 | — |
| VT | — | $14.78 | — |
| WA | — | $15.11 | — |
| WI | — | $13.18 | — |
| WV | — | $15.11 | — |
| WY | — | $15.11 | — |
How the E1701 fee compares
| Measure | Value |
|---|---|
| Rank among 2 E17 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $14.72–$30.96 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 3 | Clinical: Data |
What changed for E1701
- 2026-01-01: Average state fee rose 2.0%: $14.43 to $14.72
- 1993-01-01: E1701 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 E1701?
E1701 is the HCPCS Level II code for replacement cushions for jaw motion rehabilitation system, pkg. of 6. Short descriptor: "Repl cushions for jaw motion".
How much does Medicare pay for E1701?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $12.84–$16.34. Rural fees can be higher.
Does Medicare cover E1701?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for E1701 change in 2026?
The average non-rural state fee moved from $14.43 in 2025 to $14.72 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E1701 can be billed per day?
3 on DME suppliers (NCCI medically unlikely edits).
Related E17 codes
- E1700 — Jaw motion rehabilitation system ($41.78–$62.34)
- E1702 — Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200 ($27.33–$40.82)
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Next steps
- Run a reimbursement report for a device billed under E1701
- Watch E1701 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E1701
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.