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HCPCS K0005 · Level II · K code

K0005: Ultralightweight wheelchair, HCPCS Level II K 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); DMEPOS fee schedule: DME26-D (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 DMEPOS fee schedule 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 K0005

Medicare payment
$2,590.67 to $2,634.76
DMEPOS non-rural state fees (NU)
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
1
MAI 2
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

K0005 is a Level II code from the K section (temporary codes for DME Medicare administrative contractors), in use since 1994: "Ultralightweight wheelchair". The October 2026 DMEPOS fee schedule (category IN, inexpensive and other routinely purchased items) sets K0005 at NU (purchased, new) $2,590.67 in AZ, CA, IA and 9 more to $2,634.76 in AL, AR, CO and 34 more (floor $2,239.55, ceiling $2,634.76); RR (rental) $259.07 in AZ, CA, IA and 9 more to $263.45 in AL, AR, CO and 34 more (floor $223.93, ceiling $263.45); UE (purchased, used) $1,943.03 in AZ, CA, IA and 9 more to $1,976.01 in AL, AR, CO and 34 more (floor $1,679.61, ceiling $1,976.01). CMS caps K0005 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 K0005: 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). Nearby codes: K0003, K0007, K0002, K0001.

K0005 descriptor and code status

The October 2026 HCPCS Level II file describes K0005 as “Ultralightweight wheelchair”. It sits in the K section (temporary codes for DME Medicare administrative contractors), listed with the other K codes. Although searches often call it the "K0005 CPT code", K0005 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of K0005
FieldValue
Short descriptorUltralightweight wheelchair
Added to HCPCS1994-01-01
Last actionN (no maintenance), effective 1994-01-01
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 K0005

The October 2026 DMEPOS fee schedule (category IN, inexpensive and other routinely purchased items) sets K0005 at NU (purchased, new) $2,590.67 in AZ, CA, IA and 9 more to $2,634.76 in AL, AR, CO and 34 more (floor $2,239.55, ceiling $2,634.76); RR (rental) $259.07 in AZ, CA, IA and 9 more to $263.45 in AL, AR, CO and 34 more (floor $223.93, ceiling $263.45); UE (purchased, used) $1,943.03 in AZ, CA, IA and 9 more to $1,976.01 in AL, AR, CO and 34 more (floor $1,679.61, ceiling $1,976.01). 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.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category IN (inexpensive and other routinely purchased items). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for K0005 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
NU (purchased, new)$2,239.55 / $2,634.76$2,590.67 (AZ, CA, IA…) to $2,634.76 (AL, AR, CO…)—AK $2,616.59, HI $2,797.90, PR $2,644.29, VI $2,634.76
RR (rental)$223.93 / $263.45$259.07 (AZ, CA, IA…) to $263.45 (AL, AR, CO…)—AK $259.07, HI $259.07, PR $264.45, VI $263.45
UE (purchased, used)$1,679.61 / $1,976.01$1,943.03 (AZ, CA, IA…) to $1,976.01 (AL, AR, CO…)—AK $1,962.43, HI $2,098.42, PR $1,983.25, VI $1,976.01

Hospital outpatient (OPPS Addendum B)

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

Medically Unlikely Edits for K0005

CMS caps K0005 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 DME supplier MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for K0005 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 K0005 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists K0005 in v323r0.

K0005 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 K0005 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for K0005

1 active Local Coverage Determination and 0 billing and coding articles list K0005. 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 K0005

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists K0005

CARC 151 · N362

units of K0005 exceed the DME supplier MUE of 1 per date of service

CARC 4

the NU, RR, UE payment modifier is missing or does not match the item

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Prior authorization in Original Medicare

  • On the DMEPOS Required Prior Authorization List nationwide from October 28, 2026; the DME MAC denies a claim without an affirmed request. CMS service group: Manual wheelchair base.

Medicare Advantage plans run their own prior authorization lists. See this code on the Medicare prior authorization list.

Where QuickIntell fits for K0005 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for K0005 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS K0005

What does HCPCS code K0005 describe?

"Ultralightweight wheelchair" (short descriptor "Ultralightweight wheelchair"), in the K section (temporary codes for DME Medicare administrative contractors). Added 1994-01-01.

Is K0005 a CPT code?

It is not. K0005 belongs to the K section (temporary codes for DME Medicare administrative contractors) of HCPCS Level II, the CMS code set, not to AMA CPT. "K0005 CPT code" searches refer to it.

What does Medicare pay for K0005?

The October 2026 DMEPOS fee schedule (category IN, inexpensive and other routinely purchased items) sets K0005 at NU (purchased, new) $2,590.67 in AZ, CA, IA and 9 more to $2,634.76 in AL, AR, CO and 34 more (floor $2,239.55, ceiling $2,634.76); RR (rental) $259.07 in AZ, CA, IA and 9 more to $263.45 in AL, AR, CO and 34 more (floor $223.93, ceiling $263.45); UE (purchased, used) $1,943.03 in AZ, CA, IA and 9 more to $1,976.01 in AL, AR, CO and 34 more (floor $1,679.61, ceiling $1,976.01).

How many units of K0005 can be billed per day?

CMS caps K0005 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 DME supplier MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover K0005?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists K0005: 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.