E1228: Special back height for wheelchair
E1228 is a HCPCS Level II code for special back height for wheelchair. It belongs to the Durable Medical Equipment section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits: units per day
The most units of E1228 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0, never payable MAI 3: Date of Service Edit: Clinical · CMS Policy
- outpatient
- 0, never payable MAI 3: Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 2: Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute, no documentation overrides it. CMS MUE 2026Q4.
The CMS record for E1228
- Long descriptor
- Special back height for wheelchair
- Short descriptor
- Wheelchair spec sz spec ht b
- Added
- January 1, 1986
- BETOS
- D1D
- Pricing indicator
- 36: DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service: CMS's own analytic grouping.
Capped rental DME. Price subject to floors and ceilings.
Codes adjacent to E1228
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If E1228 is not quite right, the correct code is very often within a few positions of it.
- E1220Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification
- E1221Wheelchair with fixed arm, footrests
- E1222Wheelchair with fixed arm, elevating legrests
- E1223Wheelchair with detachable arms, footrests
- E1224Wheelchair with detachable arms, elevating legrests
- E1225Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each
- E1226Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each
- E1227Special height arms for wheelchair
- E1229Wheelchair, pediatric size, not otherwise specified
- E1230Power operated vehicle (three or four wheel nonhighway) specify brand name and model number
- E1231Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, with seating system
- E1232Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system
- E1233Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system
- E1234Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system
- E1235Wheelchair, pediatric size, rigid, adjustable, with seating system
- E1236Wheelchair, pediatric size, folding, adjustable, with seating system