K0042 HCPCS code: Standard size footplate, replacement only, each
K0042 is the HCPCS Level II code for standard size footplate, replacement only, each. The 2026 Medicare DMEPOS fee schedule pays $33.28 to $67.94 (NU, new equipment, purchased) 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. Medicare volume rose 15% from 2022 to 2024 (665 to 762 services). In 2024, 211 suppliers billed Medicare for K0042 (purchases), serving 437 beneficiaries; California, Ohio, Massachusetts accounted for 44% of services. Its average fee ranks 9 of 28 K00 codes billed NU (family range $19.23–$2,627.69); rural fees run 2% higher.
Code details
| Field | Value |
|---|---|
| Section | K codes — Temporary codes for DME MACs |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1D — Wheelchairs |
| Added | 1994-01-01 |
| Last action effective | 2017-01-01 |
2026 Medicare DMEPOS fee schedule for K0042
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $33.28 | $67.94 | — | — |
| NU | new equipment, purchased | $33.28 | $84.76 | $44.75 | $38.04 |
| RR | rental (monthly) | $3.35 | $7.99 | — | — |
| RR | rental (monthly) | $3.36 | $10.58 | $4.47 | $3.80 |
| UE | used equipment, purchased | $24.97 | $50.94 | — | — |
| UE | used equipment, purchased | $24.96 | $63.52 | $33.55 | $28.52 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $38.11 | — |
| AL | NU | $38.04 | $41.04 |
| AR | NU | $40.91 | $42.86 |
| AZ | NU | $38.04 | $41.04 |
| CA | NU | $38.04 | $41.04 |
| CO | NU | $44.75 | $45.05 |
| CT | NU | $44.75 | $45.05 |
| DC | NU | $44.75 | $45.05 |
| DE | NU | $44.75 | $45.05 |
| FL | NU | $44.75 | $45.05 |
| GA | NU | $44.75 | $45.05 |
| HI | NU | $38.11 | — |
| IA | NU | $38.04 | $41.04 |
| ID | NU | $38.04 | $41.04 |
| IL | NU | $44.75 | $45.05 |
| IN | NU | $44.75 | $45.05 |
| KS | NU | $38.04 | $41.04 |
| KY | NU | $41.25 | $43.05 |
| LA | NU | $42.08 | $43.52 |
| MA | NU | $44.75 | $45.05 |
| MD | NU | $44.75 | $45.05 |
| ME | NU | $44.75 | $45.05 |
| MI | NU | $40.25 | $42.47 |
| MN | NU | $44.75 | $45.05 |
| MO | NU | $38.04 | $41.04 |
| MS | NU | $38.04 | $41.04 |
| MT | NU | $38.04 | $41.04 |
| NC | NU | $38.04 | $41.04 |
| ND | NU | $38.04 | $41.04 |
| NE | NU | $38.04 | $41.04 |
| NH | NU | $44.75 | $45.05 |
| NJ | NU | $44.75 | $45.05 |
| NM | NU | $44.75 | $45.05 |
| NV | NU | $38.04 | $41.04 |
| NY | NU | $44.75 | $45.05 |
| OH | NU | $42.55 | $43.79 |
| OK | NU | $44.75 | $45.05 |
| OR | NU | $38.04 | $41.04 |
| PA | NU | $44.75 | $45.05 |
| PR | NU | $84.76 | — |
| RI | NU | $44.75 | $45.05 |
| SC | NU | $44.75 | $45.05 |
| SD | NU | $38.04 | $41.04 |
| TN | NU | $44.75 | $45.05 |
| TX | NU | $44.75 | $45.05 |
| UT | NU | $38.04 | $41.04 |
| VA | NU | $44.72 | $45.04 |
| VI | NU | $45.05 | — |
| VT | NU | $44.75 | $45.05 |
| WA | NU | $38.04 | $41.04 |
| WI | NU | $44.75 | $45.05 |
| WV | NU | $44.75 | $45.05 |
| WY | NU | $38.04 | $41.04 |
| AK | RR | $3.84 | — |
| AL | RR | $3.80 | $4.10 |
| AR | RR | $4.12 | $4.30 |
| AZ | RR | $3.80 | $4.10 |
| CA | RR | $3.80 | $4.10 |
| CO | RR | $4.47 | $4.50 |
| CT | RR | $4.47 | $4.50 |
| DC | RR | $4.47 | $4.50 |
| DE | RR | $4.47 | $4.50 |
| FL | RR | $4.47 | $4.50 |
| GA | RR | $4.47 | $4.50 |
| HI | RR | $3.84 | — |
| IA | RR | $3.80 | $4.10 |
| ID | RR | $3.80 | $4.10 |
| IL | RR | $4.47 | $4.50 |
| IN | RR | $4.47 | $4.50 |
| KS | RR | $3.80 | $4.10 |
| KY | RR | $4.17 | $4.33 |
| LA | RR | $4.24 | $4.36 |
| MA | RR | $4.47 | $4.50 |
| MD | RR | $4.47 | $4.50 |
| ME | RR | $4.47 | $4.50 |
| MI | RR | $4.02 | $4.24 |
| MN | RR | $4.47 | $4.50 |
| MO | RR | $3.80 | $4.10 |
| MS | RR | $3.80 | $4.10 |
| MT | RR | $3.80 | $4.10 |
| NC | RR | $3.80 | $4.10 |
| ND | RR | $3.80 | $4.10 |
| NE | RR | $3.80 | $4.10 |
| NH | RR | $4.47 | $4.50 |
| NJ | RR | $4.47 | $4.50 |
| NM | RR | $4.47 | $4.50 |
| NV | RR | $3.80 | $4.10 |
| NY | RR | $4.47 | $4.50 |
| OH | RR | $4.28 | $4.39 |
| OK | RR | $4.47 | $4.50 |
| OR | RR | $3.80 | $4.10 |
| PA | RR | $4.47 | $4.50 |
| PR | RR | $10.58 | — |
| RI | RR | $4.47 | $4.50 |
| SC | RR | $4.47 | $4.50 |
| SD | RR | $3.80 | $4.10 |
| TN | RR | $4.47 | $4.50 |
| TX | RR | $4.47 | $4.50 |
| UT | RR | $3.80 | $4.10 |
| VA | RR | $4.47 | $4.50 |
| VI | RR | $4.50 | — |
| VT | RR | $4.47 | $4.50 |
| WA | RR | $3.80 | $4.10 |
| WI | RR | $4.47 | $4.50 |
| WV | RR | $4.47 | $4.50 |
| WY | RR | $3.80 | $4.10 |
| AK | UE | $28.59 | — |
| AL | UE | $28.52 | $30.77 |
| AR | UE | $30.70 | $32.16 |
| AZ | UE | $28.52 | $30.77 |
| CA | UE | $28.52 | $30.77 |
| CO | UE | $33.55 | $33.78 |
| CT | UE | $33.55 | $33.78 |
| DC | UE | $33.55 | $33.78 |
| DE | UE | $33.55 | $33.78 |
| FL | UE | $33.55 | $33.78 |
| GA | UE | $33.55 | $33.78 |
| HI | UE | $28.59 | — |
| IA | UE | $28.52 | $30.77 |
| ID | UE | $28.52 | $30.77 |
| IL | UE | $33.55 | $33.78 |
| IN | UE | $33.55 | $33.78 |
| KS | UE | $28.52 | $30.77 |
| KY | UE | $30.95 | $32.29 |
| LA | UE | $31.57 | $32.65 |
| MA | UE | $33.55 | $33.78 |
| MD | UE | $33.55 | $33.78 |
| ME | UE | $33.55 | $33.78 |
| MI | UE | $30.19 | $31.86 |
| MN | UE | $33.55 | $33.78 |
| MO | UE | $28.52 | $30.77 |
| MS | UE | $28.52 | $30.77 |
| MT | UE | $28.52 | $30.77 |
| NC | UE | $28.52 | $30.77 |
| ND | UE | $28.52 | $30.77 |
| NE | UE | $28.52 | $30.77 |
| NH | UE | $33.55 | $33.78 |
| NJ | UE | $33.55 | $33.78 |
| NM | UE | $33.55 | $33.78 |
| NV | UE | $28.52 | $30.77 |
| NY | UE | $33.55 | $33.78 |
| OH | UE | $31.90 | $32.85 |
| OK | UE | $33.55 | $33.78 |
| OR | UE | $28.52 | $30.77 |
| PA | UE | $33.55 | $33.78 |
| PR | UE | $63.52 | — |
| RI | UE | $33.55 | $33.78 |
| SC | UE | $33.55 | $33.78 |
| SD | UE | $28.52 | $30.77 |
| TN | UE | $33.55 | $33.78 |
| TX | UE | $33.55 | $33.78 |
| UT | UE | $28.52 | $30.77 |
| VA | UE | $33.55 | $33.78 |
| VI | UE | $33.78 | — |
| VT | UE | $33.55 | $33.78 |
| WA | UE | $28.52 | $30.77 |
| WI | UE | $33.55 | $33.78 |
| WV | UE | $33.55 | $33.78 |
| WY | UE | $28.52 | $30.77 |
How the K0042 fee compares
| Measure | Value |
|---|---|
| Rank among 28 K00 codes billed NU (lowest = 1) | 9 |
| Family fee range (average of state fees) | $19.23–$2,627.69 |
| Rural fee uplift | 2.2% |
Who bills K0042 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 211 |
| Referring clinicians | 434 |
| Medicare beneficiaries | 437 |
| States with claims | 14 |
| Share of services in top 3 states (California, Ohio, Massachusetts) | 44% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 199 | 399 |
| 2023 | 193 | 443 |
| 2024 | 211 | 437 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for K0042, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 665 | 399 | $35.33 | $26.51 |
| 2023 | 756 | 443 | $38.42 | $29.43 |
| 2024 | 762 | 437 | $39.23 | $29.96 |
States with the most K0042 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 136 | $26.43 |
| Ohio | 43 | $29.30 |
| Massachusetts | 42 | $33.47 |
| Florida | 33 | $32.40 |
| Minnesota | 32 | $31.18 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
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 K0042
- 2026-01-01: Average state fee (NU) rose 2.2%: $40.04 to $40.91
- 2026-01-01: Average state fee (RR) rose 2.2%: $4.04 to $4.13
- 2026-01-01: Average state fee (UE) rose 2.2%: $30.02 to $30.68
- 1994-01-01: K0042 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 K0042?
K0042 is the HCPCS Level II code for standard size footplate, replacement only, each. Short descriptor: "Standard size ftplate rep ea".
How much does Medicare pay for K0042?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $33.28–$67.94; NU (new equipment, purchased): $33.28–$84.76; RR (rental (monthly)): $3.35–$7.99; RR (rental (monthly)): $3.36–$10.58; UE (used equipment, purchased): $24.97–$50.94; UE (used equipment, purchased): $24.96–$63.52. Rural fees can be higher.
Does Medicare cover K0042?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for K0042 change in 2026?
The average non-rural state fee for NU moved from $40.04 in 2025 to $40.91 in 2026 (+2.2%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of K0042 can be billed per day?
2 on DME suppliers (NCCI medically unlikely edits).
Related K00 codes
- K0001 — Standard wheelchair ($25.23–$53.63)
- K0002 — Standard hemi (low seat) wheelchair ($38.93–$101.05)
- K0003 — Lightweight wheelchair ($36.91–$115.29)
- K0004 — High strength, lightweight wheelchair ($48.55–$163.93)
- K0005 — Ultralightweight wheelchair ($259.07–$2,797.90)
- K0006 — Heavy duty wheelchair ($68.77–$169.03)
- K0007 — Extra heavy duty wheelchair ($96.40–$211.59)
- K0008 — Custom manual wheelchair/base
- K0009 — Other manual wheelchair/base ($101.86–$122.26)
- K0010 — Standard - weight frame motorized/power wheelchair ($516.03–$1,144.42)
- K0011 — Standard - weight frame motorized/power wheelchair with programmable control parameters for speed adjustment, tremor dampening, acceleration control and braking ($641.58–$810.57)
- K0012 — Lightweight portable motorized/power wheelchair ($393.59–$543.05)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under K0042
- Watch K0042 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for K0042
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.