K1027 HCPCS code: Oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment
K1027 is the HCPCS Level II code for oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers.
Code details
| Field | Value |
|---|---|
| Section | K codes — Temporary codes for DME MACs |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 99 |
| BETOS category | Z2 |
| Added | 2021-10-01 |
| Last action effective | 2021-10-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Nature of Equipment |
| outpatient hospital claims | 1 | Nature of Equipment |
| practitioner claims | 1 | Nature of Equipment |
What changed for K1027
- 2021-10-01: K1027 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 K1027?
K1027 is the HCPCS Level II code for oral device/appliance used to reduce upper airway collapsibility, without fixed mechanical hinge, custom fabricated, includes fitting and adjustment. Short descriptor: "Oral dev without fix mech".
Does Medicare cover K1027?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of K1027 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related K10 codes
- K1001 — Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type
- K1002 — Cranial electrotherapy stimulation (ces) system, any type
- K1003 — Whirlpool tub, walk-in, portable
- K1004 — Low frequency ultrasonic diathermy treatment device for home use
- K1005 — Disposable collection and storage bag for breast milk, any size, any type, each
- K1006 — Suction pump, home model, portable or stationary, electric, any type, for use with external urine management system
- K1007 — Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors ($95,081.03–$95,081.03)
- K1009 — Speech volume modulation system, any type, including all components and accessories
- K1010 — Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each
- K1011 — Activation device for intraurethral drainage device with valve, replacement only, each
- K1012 — Charger and base station for intraurethral activation device, replacement only
- K1013 — Enema tube, with or without adapter, any type, replacement only, each
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Next steps
- Run a reimbursement report for a device billed under K1027
- Watch K1027 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for K1027
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; 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.