E2227 HCPCS code: Manual wheelchair accessory, gear reduction drive wheel, each
E2227 is the HCPCS Level II code for manual wheelchair accessory, gear reduction drive wheel, each. The 2026 Medicare DMEPOS fee schedule pays $256.33 to $273.28 (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 29 of 29 E22 codes billed RR (family range $0.73–$262.18).
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 36 — DMEPOS: capped rental item |
| BETOS category | D1D — Wheelchairs |
| Added | 2008-01-01 |
| Last action effective | 2014-04-01 |
2026 Medicare DMEPOS fee schedule for E2227
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| RR | rental (monthly) | $256.33 | $273.28 | $266.62 | $226.63 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | RR | $256.33 | — |
| AL | RR | $266.62 | — |
| AR | RR | $266.62 | — |
| AZ | RR | $256.33 | — |
| CA | RR | $266.62 | — |
| CO | RR | $266.62 | — |
| CT | RR | $256.33 | — |
| DC | RR | $266.62 | — |
| DE | RR | $256.33 | — |
| FL | RR | $256.33 | — |
| GA | RR | $266.62 | — |
| HI | RR | $266.62 | — |
| IA | RR | $266.62 | — |
| ID | RR | $256.33 | — |
| IL | RR | $266.62 | — |
| IN | RR | $266.62 | — |
| KS | RR | $256.33 | — |
| KY | RR | $266.62 | — |
| LA | RR | $266.62 | — |
| MA | RR | $256.33 | — |
| MD | RR | $256.33 | — |
| ME | RR | $256.33 | — |
| MI | RR | $266.62 | — |
| MN | RR | $266.62 | — |
| MO | RR | $266.62 | — |
| MS | RR | $266.62 | — |
| MT | RR | $256.33 | — |
| NC | RR | $264.05 | — |
| ND | RR | $266.62 | — |
| NE | RR | $256.33 | — |
| NH | RR | $256.33 | — |
| NJ | RR | $256.33 | — |
| NM | RR | $266.62 | — |
| NV | RR | $256.33 | — |
| NY | RR | $256.33 | — |
| OH | RR | $266.62 | — |
| OK | RR | $266.62 | — |
| OR | RR | $256.33 | — |
| PA | RR | $256.33 | — |
| PR | RR | $273.28 | — |
| RI | RR | $256.33 | — |
| SC | RR | $266.62 | — |
| SD | RR | $266.62 | — |
| TN | RR | $266.62 | — |
| TX | RR | $256.33 | — |
| UT | RR | $266.62 | — |
| VA | RR | $256.33 | — |
| VI | RR | $256.33 | — |
| VT | RR | $256.33 | — |
| WA | RR | $266.62 | — |
| WI | RR | $266.62 | — |
| WV | RR | $266.62 | — |
| WY | RR | $264.05 | — |
How the E2227 fee compares
| Measure | Value |
|---|---|
| Rank among 29 E22 codes billed RR (lowest = 1) | 29 |
| Family fee range (average of state fees) | $0.73–$262.18 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Code Descriptor / CPT Instruction |
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 E2227
- 2026-01-01: Average state fee (RR) rose 2.0%: $257.04 to $262.18
- 2008-01-01: E2227 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 E2227?
E2227 is the HCPCS Level II code for manual wheelchair accessory, gear reduction drive wheel, each. Short descriptor: "Gear reduction drive wheel".
How much does Medicare pay for E2227?
Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $256.33–$273.28. Rural fees can be higher.
Does Medicare cover E2227?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for E2227 change in 2026?
The average non-rural state fee for RR moved from $257.04 in 2025 to $262.18 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of E2227 can be billed per day?
2 on DME suppliers (NCCI medically unlikely edits).
Related E22 codes
- E2201 — Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches ($32.96–$638.07)
- E2202 — Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches ($48.36–$810.59)
- E2203 — Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches ($47.63–$819.21)
- E2204 — Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches ($82.59–$1,391.06)
- E2205 — Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each ($3.85–$55.87)
- E2206 — Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each ($4.34–$69.59)
- E2207 — Wheelchair accessory, crutch and cane holder, each ($5.23–$74.15)
- E2208 — Wheelchair accessory, cylinder tank carrier, each ($8.31–$175.04)
- E2209 — Accessory, arm trough, with or without hand support, each ($9.54–$157.98)
- E2210 — Wheelchair accessory, bearings, any type, replacement only, each ($0.58–$8.89)
- E2211 — Manual wheelchair accessory, pneumatic propulsion tire, any size, each ($3.97–$178.90)
- E2212 — Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each ($0.70–$10.06)
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Next steps
- Run a reimbursement report for a device billed under E2227
- Watch E2227 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E2227
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.