2010 HCPCS Schedule - DE Medical Assistance Program

E1093 WHEELCHAIR WIDE W/ FOOT REST 3 $995.60
E1100 WHCHR S-RECL FXD ARM LEG RES 3 $935.10
E1110 WHEELCHAIR SEMI-RECL DETACH 3 $778.30
E1130 WHLCHR STAND FXD ARM FT REST 3 $420.70
E1140 WHEELCHAIR STANDARD DETACH A 3 $647.00
E1150 WHEELCHAIR STANDARD W/ LEG R 3 $735.00
E1160 WHEELCHAIR FIXED ARMS 3 $563.00
E1161 MANUAL ADULT WC W TILTINSPAC 5 $0.00
E1170 WHLCHR AMPU FXD ARM LEG REST 3 $804.60
E1171 WHEELCHAIR AMPUTEE W/O LEG R 3 $643.40
E1172 WHEELCHAIR AMPUTEE DETACH AR 3 $827.40
E1180 WHEELCHAIR AMPUTEE W/ FOOT R 3 $776.00
E1190 WHEELCHAIR AMPUTEE W/ LEG RE 3 $1,054.70
E1195 WHEELCHAIR AMPUTEE HEAVY DUT 3 $961.90
E1200 WHEELCHAIR AMPUTEE FIXED ARM 3 $689.20
E1210 WHLCHR MOTO FUL ARM LEG REST O $0.00
E1211 WHEELCHAIR MOTORIZED W/ DET O $0.00
E1212 WHEELCHAIR MOTORIZED W FULL O $0.00
E1213 WHEELCHAIR MOTORIZED W/ DET O $0.00
E1220 WHLCHR SPECIAL SIZE/CONSTRC 5 $0.00
E1221 WHEELCHAIR SPEC SIZE W FOOT 3 $428.10
E1222 WHEELCHAIR SPEC SIZE W/ LEG 3 $610.70
E1223 WHEELCHAIR SPEC SIZE W FOOT 3 $666.80
E1224 WHEELCHAIR SPEC SIZE W/ LEG 3 $731.10
E1225 MANUAL SEMI-RECLINING BACK 3 $407.20
E1226 MANUAL FULLY RECLINING BACK 3 $522.01
E1227 WHEELCHAIR SPEC SZ SPEC HT A 3 $265.23
E1228 WHEELCHAIR SPEC SZ SPEC HT B 3 $214.50
E1229 PEDIATRIC WHEELCHAIR NOS 6 $0.00
E1230 POWER OPERATED VEHICLE 3 $1,946.92
E1231 RIGID PED W/C TILT-IN-SPACE 5 $0.00
E1232 FOLDING PED WC TILT-IN-SPACE 5 $0.00
E1233 RIG PED WC TLTNSPC W/O SEAT 5 $0.00
E1234 FLD PED WC TLTNSPC W/O SEAT 5 $0.00
E1235 RIGID PED WC ADJUSTABLE 5 $0.00
E1236 FOLDING PED WC ADJUSTABLE 5 $0.00
E1237 RGD PED WC ADJSTABL W/O SEAT 5 $0.00
E1238 FLD PED WC ADJSTABL W/O SEAT 5 $0.00
E1239 PED POWER WHEELCHAIR NOS 6 $0.00
E1240 WHCHR LITWT DET ARM LEG REST 3 $928.10
E1250 WHEELCHAIR LIGHTWT FIXED ARM 3 $684.70
E1260 WHEELCHAIR LIGHTWT FOOT REST 3 $713.70
E1270 WHEELCHAIR LIGHTWEIGHT LEG R 3 $604.40
E1280 WHCHR H-DUTY DET ARM LEG RES 3 $1,005.00
E1285 WHEELCHAIR HEAVY DUTY FIXED 3 $923.50
E1290 WHEELCHAIR HVY DUTY DETACH A 3 $958.20
E1295 WHEELCHAIR HEAVY DUTY FIXED 3 $1,046.20
E1296 WHEELCHAIR SPECIAL SEAT HEIG 3 $399.82
E1297 WHEELCHAIR SPECIAL SEAT DEPT 3 $85.07