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HCPCS E1229 · Level II · DME code

E1229: Wheelchair, pediatric size, not otherwise specified, HCPCS Level II DME code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for E1229

Medicare payment
none in these files
no PFS, DMEPOS, CLFS, OPPS or ASC amount; pricing indicator 32
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
0
MAI 3
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

HCPCS Level II E1229 reads "Wheelchair, pediatric size, not otherwise specified" in the October 2026 file; it dates from 2005. None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E1229; its HCPCS pricing indicator is 32 (DMEPOS inexpensive and routinely purchased DME (floors and ceilings)). CMS caps E1229 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. 1 active LCD lists E1229: L33788 (Manual Wheelchair Bases). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1D (wheelchairs); pricing indicator 32; type of service A (used DME), P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). 12 other active codes open with "Wheelchair"; related codes: E1236, E1231, E1232, E1233.

E1229 descriptor and code status

The October 2026 HCPCS Level II file describes E1229 as “Wheelchair, pediatric size, not otherwise specified”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E1229
FieldValue
Short descriptorPediatric wheelchair nos
Added to HCPCS2005-01-01
Last actionN (no maintenance), effective 2005-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator32: DMEPOS inexpensive and routinely purchased DME (floors and ceilings)
BETOS categoryD1D: wheelchairs
Type of serviceA: used DME; P: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME

Medicare payment for E1229

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E1229; its HCPCS pricing indicator is 32 (DMEPOS inexpensive and routinely purchased DME (floors and ceilings)). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Hospital outpatient (OPPS Addendum B)

Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.

Medically Unlikely Edits for E1229

CMS caps E1229 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for E1229 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction

The MUE lookup for E1229 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E1229 in v323r0.

E1229 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check E1229 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E1229

1 active Local Coverage Determination and 0 billing and coding articles list E1229. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on E1229

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists E1229

CARC 151 · N362

units of E1229 exceed the practitioner MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for E1229 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for E1229 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E1229

What does HCPCS code E1229 describe?

"Wheelchair, pediatric size, not otherwise specified" (short descriptor "Pediatric wheelchair nos"), in the E section (durable medical equipment). Added 2005-01-01.

Is E1229 a CPT code?

It is not. E1229 belongs to the E section (durable medical equipment) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for E1229?

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for E1229; its HCPCS pricing indicator is 32 (DMEPOS inexpensive and routinely purchased DME (floors and ceilings)).

How many units of E1229 can be billed per day?

CMS caps E1229 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. For the practitioner MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover E1229?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists E1229: L33788 (Manual Wheelchair Bases).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.