E1804 HCPCS code: Dynamic adjustable elbow flexion only device, includes soft interface material
E1804 is the HCPCS Level II code for dynamic adjustable elbow flexion only device, includes soft interface material. The 2026 Medicare DMEPOS fee schedule pays $140.52 to $222.55 (RR, rental (monthly)) 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 2 per day on DME suppliers. Its average fee ranks 9 of 31 E18 codes billed RR (family range $11.44–$648.01).
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 36 — DMEPOS: capped rental item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2025-01-01 |
| Last action effective | 2025-01-01 |
2026 Medicare DMEPOS fee schedule for E1804
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $140.52 | $222.55 | $174.58 | $148.39 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $222.55 | — |
| AL | RR | $148.39 | — |
| AR | RR | $148.39 | — |
| AZ | RR | $174.58 | — |
| CA | RR | $174.58 | — |
| CO | RR | $148.39 | — |
| CT | RR | $148.39 | — |
| DC | RR | $174.58 | — |
| DE | RR | $148.39 | — |
| FL | RR | $148.39 | — |
| GA | RR | $148.39 | — |
| HI | RR | $197.05 | — |
| IA | RR | $174.58 | — |
| ID | RR | $174.58 | — |
| IL | RR | $174.58 | — |
| IN | RR | $174.58 | — |
| KS | RR | $174.58 | — |
| KY | RR | $148.39 | — |
| LA | RR | $148.39 | — |
| MA | RR | $148.39 | — |
| MD | RR | $174.58 | — |
| ME | RR | $148.64 | — |
| MI | RR | $174.58 | — |
| MN | RR | $174.58 | — |
| MO | RR | $174.58 | — |
| MS | RR | $148.39 | — |
| MT | RR | $174.58 | — |
| NC | RR | $148.39 | — |
| ND | RR | $174.58 | — |
| NE | RR | $174.58 | — |
| NH | RR | $148.39 | — |
| NJ | RR | $148.39 | — |
| NM | RR | $148.39 | — |
| NV | RR | $174.58 | — |
| NY | RR | $148.39 | — |
| OH | RR | $174.58 | — |
| OK | RR | $148.39 | — |
| OR | RR | $174.58 | — |
| PA | RR | $148.39 | — |
| PR | RR | $140.52 | — |
| RI | RR | $148.39 | — |
| SC | RR | $148.39 | — |
| SD | RR | $174.58 | — |
| TN | RR | $148.39 | — |
| TX | RR | $151.41 | — |
| UT | RR | $174.58 | — |
| VA | RR | $174.58 | — |
| VI | RR | $148.39 | — |
| VT | RR | $148.39 | — |
| WA | RR | $174.58 | — |
| WI | RR | $174.58 | — |
| WV | RR | $174.58 | — |
| WY | RR | $174.58 | — |
How the E1804 fee compares
| Measure | Value |
|---|---|
| Rank among 31 E18 codes billed RR (lowest = 1) | 9 |
| Family fee range (average of state fees) | $11.44–$648.01 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
What changed for E1804
- 2026-01-01: Average state fee (RR) rose 2.0%: $159.78 to $162.97
- 2025-01-01: E1804 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 E1804?
E1804 is the HCPCS Level II code for dynamic adjustable elbow flexion only device, includes soft interface material. Short descriptor: "Adjust elbow flexion dev".
How much does Medicare pay for E1804?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $140.52–$222.55. Rural fees can be higher.
Does Medicare cover E1804?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for E1804 change in 2026?
The average non-rural state fee for RR moved from $159.78 in 2025 to $162.97 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E1804 can be billed per day?
2 on DME suppliers (NCCI medically unlikely edits).
Related E18 codes
- E1800 — Dynamic adjustable elbow extension and flexion device, includes soft interface material ($140.52–$222.55)
- E1801 — Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories ($156.28–$215.62)
- E1802 — Dynamic adjustable forearm pronation/supination device, includes soft interface material ($465.75–$558.88)
- E1803 — Dynamic adjustable elbow extension only device, includes soft interface material ($140.52–$222.55)
- E1805 — Dynamic adjustable wrist extension and flexion device, includes soft interface material ($114.31–$222.55)
- E1806 — Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories ($128.32–$177.02)
- E1807 — Dynamic adjustable wrist extension only device, includes soft interface material ($114.31–$222.55)
- E1808 — Dynamic adjustable wrist flexion only device, includes soft interface material ($114.31–$222.55)
- E1810 — Dynamic adjustable knee extension and flexion device, includes soft interface material ($142.48–$222.55)
- E1811 — Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories ($162.46–$224.19)
- E1812 — Dynamic knee, extension/flexion device with active resistance control ($122.55–$147.07)
- E1813 — Dynamic adjustable knee extension only device, includes soft interface material ($142.48–$222.55)
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Next steps
- Run a reimbursement report for a device billed under E1804
- Watch E1804 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E1804
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.