E1200 — Amputee wheelchair, fixed full length arms, swing away detachable footrest
HCPCS Level II E-code · short descriptor: “Wheelchair amputee fixed arm”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Capped rental
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
E1200 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $105.40 to $179.59 depending on state and rural status.
Former-CBA payment limits: ceiling $124.00 · floor $105.40
| State | Non-rural | Rural |
|---|---|---|
| AK | $135.72 | — |
| AL | $105.40 | — |
| AR | $124.00 | — |
| AZ | $124.00 | — |
| CA | $124.00 | — |
| CO | $105.40 | — |
| CT | $105.40 | — |
| DC | $112.92 | — |
| DE | $109.06 | — |
| FL | $105.40 | — |
| GA | $105.40 | — |
| HI | $145.13 | — |
| IA | $105.57 | — |
| ID | $124.00 | — |
| IL | $124.00 | — |
| IN | $124.00 | — |
| KS | $116.46 | — |
| KY | $119.39 | — |
| LA | $119.10 | — |
| MA | $124.00 | — |
| MD | $124.00 | — |
| ME | $124.00 | — |
| MI | $124.00 | — |
| MN | $105.40 | — |
| MO | $105.40 | — |
| MS | $105.40 | — |
| MT | $124.00 | — |
| NC | $106.71 | — |
| ND | $124.00 | — |
| NE | $114.74 | — |
| NH | $106.00 | — |
| NJ | $115.72 | — |
| NM | $124.00 | — |
| NV | $124.00 | — |
| NY | $124.00 | — |
| OH | $105.40 | — |
| OK | $124.00 | — |
| OR | $124.00 | — |
| PA | $124.00 | — |
| PR | $179.59 | — |
| RI | $105.40 | — |
| SC | $105.40 | — |
| SD | $124.00 | — |
| TN | $124.00 | — |
| TX | $124.00 | — |
| UT | $105.40 | — |
| VA | $124.00 | — |
| VI | $124.00 | — |
| VT | $110.78 | — |
| WA | $124.00 | — |
| WI | $124.00 | — |
| WV | $105.40 | — |
| WY | $124.00 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related E-codes
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