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
HCPCS Level II E-code · short descriptor: “Sps/pass elbow device”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- 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.
E1801 Medicare fee schedule (April 2026)
RR — Monthly rental Capped rental
Medicare allowable ranges from $156.28 to $215.62 depending on state and rural status.
Former-CBA payment limits: ceiling $183.86 · floor $156.28
| State | Non-rural | Rural |
|---|---|---|
| AK | $208.99 | — |
| AL | $180.06 | — |
| AR | $183.86 | — |
| AZ | $170.67 | — |
| CA | $175.17 | — |
| CO | $183.86 | — |
| CT | $183.86 | — |
| DC | $183.86 | — |
| DE | $179.45 | — |
| FL | $168.29 | — |
| GA | $178.36 | — |
| HI | $173.04 | — |
| IA | $183.86 | — |
| ID | $183.86 | — |
| IL | $183.86 | — |
| IN | $183.86 | — |
| KS | $183.86 | — |
| KY | $183.86 | — |
| LA | $180.59 | — |
| MA | $183.86 | — |
| MD | $173.41 | — |
| ME | $183.86 | — |
| MI | $175.83 | — |
| MN | $183.86 | — |
| MO | $183.86 | — |
| MS | $164.77 | — |
| MT | $165.80 | — |
| NC | $183.86 | — |
| ND | $165.57 | — |
| NE | $183.86 | — |
| NH | $183.86 | — |
| NJ | $172.56 | — |
| NM | $162.52 | — |
| NV | $174.76 | — |
| NY | $178.26 | — |
| OH | $183.86 | — |
| OK | $183.86 | — |
| OR | $183.86 | — |
| PA | $176.22 | — |
| PR | $215.62 | — |
| RI | $156.28 | — |
| SC | $177.11 | — |
| SD | $180.37 | — |
| TN | $172.35 | — |
| TX | $183.86 | — |
| UT | $183.86 | — |
| VA | $173.60 | — |
| VI | $183.86 | — |
| VT | $183.86 | — |
| WA | $183.86 | — |
| WI | $183.86 | — |
| WV | $177.66 | — |
| WY | $179.78 | — |
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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