Walkers and Related Accessories
Akron, OH 4 Albany-Schenectady-Troy, NY 6 Albuquerque, NM 8 Allentown-Bethlehem-Easton, PA-NJ 11 Asheville, NC 13 Atlanta-Sandy Springs-Marietta, GA 16 Augusta-Richmond County, GA-SC 18 Austin-Round Rock-San Marcos, TX 21 Bakersfield-Delano, CA 23 Baltimore-Towson, MD 26 Baton Rouge, LA 28 Beaumont-Port Arthur, TX 31 Birmingham-Hoover, AL 33 Boise City-Nampa, ID 36 Boston-Cambridge-Quincy, MA-NH 38 Bridgeport-Stamford-Norwalk, CT 41 Bronx-Manhattan, NY CBA 43 Buffalo-Niagara Falls, NY 46 Cape Coral-Fort Myers, FL 48 Central-Chicago Metro CBA 50 Charleston-North Charleston-Summerville, SC 53 Chattanooga, TN-GA 55 Colorado Springs, CO 58 Columbia, SC 60 Columbus, OH 63 Dayton, OH 65 Deltona-Daytona Beach-Ormond Beach, FL 68 Denver-Aurora-Broomfield, CO 70
Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Round 2
Single Payment Amounts
Detroit-Warren-Livonia, MI 73 El Paso, TX 75 Flint, MI 78 Fresno, CA 80 Grand Rapids-Wyoming, MI 83 Greensboro-High Point, NC 85 Greenville-Mauldin-Easley, SC 88 Hartford-West Hartford-East Hartford, CT 90 Honolulu, HI 92 Houston-Sugar Land-Baytown, TX 95 Huntington-Ashland, WV-KY-OH 97 Indiana-Chicago Metro 100 Indianapolis-Carmel, IN 102 Jackson, MS 105 Jacksonville, FL 107 Knoxville, TN 110 Lakeland-Winter Haven, FL 112 Las Vegas-Paradise, NV 115 Little Rock-North Little Rock-Conway, AR 117 Los Angeles County CBA 120 Louisville/Jefferson County, KY-IN 122 McAllen-Edinburg-Mission, TX 125 Memphis, TN-MS-AR 127 Milwaukee-Waukesha-West Allis, WI 130 Minneapolis-St. Paul-Bloomington, MN-WI 132 Nashville-Davidson--Murfreesboro--Franklin, TN 134 Nassau-Brooklyn-Queens-Richmond County Metro CBA 137 New Haven-Milford, CT 139 New Orleans-Metairie-Kenner, LA 142 North East NY CBA Metro 144 North Port-Bradenton-Sarasota, FL 147 Northern NJ Metro CBA 149 Northern-Chicago Metro CBA 152 Ocala, FL 154 Oklahoma City, OK 157 Omaha-Council Bluffs, NE-IA 159 Orange County CBA 162 Oxnard-Thousand Oaks-Ventura, CA 164
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 2 of 251
Palm Bay-Melbourne-Titusville, FL 167 Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 169 Phoenix-Mesa-Glendale, AZ 172 Portland-Vancouver-Hillsboro, OR-WA 174 Poughkeepsie-Newburgh-Middletown, NY 176 Providence-New Bedford-Fall River, RI-MA 179 Raleigh-Cary, NC 181 Richmond, VA 184 Rochester, NY 186 Sacramento--Arden-Arcade--Roseville, CA 189 Salt Lake City, UT 191 San Antonio-New Braunfels, TX 194 San Diego-Carlsbad-San Marcos, CA 196 San Francisco-Oakland-Fremont, CA 199 San Jose-Sunnyvale-Santa Clara, CA 201 Scranton--Wilkes-Barre, PA 204 Seattle-Tacoma-Bellevue, WA 206 South-West-Chicago-Metro CBA 209 Southern NY Metro CBA 211 Springfield, MA 214 St. Louis, MO-IL 216 Stockton, CA 218 Suffolk County CBA 221 Syracuse, NY 223 Tampa-St. Petersburg-Clearwater, FL 226 Toledo, OH 228 Tucson, AZ 231 Tulsa, OK 233 Virginia Beach-Norfolk-Newport News, VA-NC 236 Visalia-Porterville, CA 238 Washington-Arlington-Alexandria, DC-VA-MD-WV 241 Wichita, KS 243 Worcester, MA 246 Youngstown-Warren-Boardman, OH-PA 248
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 3 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Akron, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.50
Akron, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.85
Akron, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $28.88
Akron, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.78
Akron, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.88
Akron, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.09
Akron, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $220.50
Akron, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $22.05
Akron, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $165.38
Akron, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $54.07
Akron, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.41
Akron, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.55
Akron, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $45.00
Akron, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.50
Akron, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $33.75
Akron, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $294.04
Akron, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $29.40
Walkers and Related Accessories
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 4 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Akron, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $220.53
Akron, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $67.38
Akron, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $6.74
Akron, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $50.54
Akron, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $95.47
Akron, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.55
Akron, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $71.60
Akron, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.50
Akron, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.55
Akron, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.63
Akron, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $15.10
Akron, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.51
Akron, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $11.33
Akron, OH E0156 SEAT ATTACHMENT, WALKER NU $13.32
Akron, OH E0156 SEAT ATTACHMENT, WALKER RR $1.33
Akron, OH E0156 SEAT ATTACHMENT, WALKER UE $9.99
Akron, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $41.16
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 5 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Akron, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.12
Akron, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $30.87
Akron, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.00
Akron, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.70
Akron, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.75
Akron, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.11
Akron, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.11
Akron, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.33
Albany-Schenectady-Troy, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.98
Albany-Schenectady-Troy, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
Albany-Schenectady-Troy, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.49
Albany-Schenectady-Troy, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.50
Albany-Schenectady-Troy, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.85
Albany-Schenectady-Troy, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $28.88
Albany-Schenectady-Troy, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $256.91
Albany-Schenectady-Troy, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.69
Albany-Schenectady-Troy, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $192.68
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 6 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Albany-Schenectady-Troy, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $62.92
Albany-Schenectady-Troy, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.29
Albany-Schenectady-Troy, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.19
Albany-Schenectady-Troy, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $46.50
Albany-Schenectady-Troy, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.65
Albany-Schenectady-Troy, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $34.88
Albany-Schenectady-Troy, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $362.86
Albany-Schenectady-Troy, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.29
Albany-Schenectady-Troy, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $272.15
Albany-Schenectady-Troy, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $67.50
Albany-Schenectady-Troy, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $6.75
Albany-Schenectady-Troy, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $50.63
Albany-Schenectady-Troy, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $90.06
Albany-Schenectady-Troy, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.01
Albany-Schenectady-Troy, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $67.55
Albany-Schenectady-Troy, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.80
Albany-Schenectady-Troy, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.98
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Albany-Schenectady-Troy, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.85
Albany-Schenectady-Troy, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $15.00
Albany-Schenectady-Troy, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.50
Albany-Schenectady-Troy, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $11.25
Albany-Schenectady-Troy, NY E0156 SEAT ATTACHMENT, WALKER NU $14.76
Albany-Schenectady-Troy, NY E0156 SEAT ATTACHMENT, WALKER RR $1.48
Albany-Schenectady-Troy, NY E0156 SEAT ATTACHMENT, WALKER UE $11.07
Albany-Schenectady-Troy, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $47.03
Albany-Schenectady-Troy, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.70
Albany-Schenectady-Troy, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $35.27
Albany-Schenectady-Troy, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.08
Albany-Schenectady-Troy, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.71
Albany-Schenectady-Troy, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.81
Albany-Schenectady-Troy, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.28
Albany-Schenectady-Troy, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.23
Albany-Schenectady-Troy, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.21
Albuquerque, NM E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.82
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Albuquerque, NM E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.38
Albuquerque, NM E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.87
Albuquerque, NM E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.69
Albuquerque, NM E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.27
Albuquerque, NM E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.02
Albuquerque, NM E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $234.73
Albuquerque, NM E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.47
Albuquerque, NM E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $176.05
Albuquerque, NM E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.00
Albuquerque, NM E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.90
Albuquerque, NM E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.75
Albuquerque, NM E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Albuquerque, NM E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Albuquerque, NM E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Albuquerque, NM E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $345.90
Albuquerque, NM E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $34.59
Albuquerque, NM E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $259.43
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Albuquerque, NM E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.62
Albuquerque, NM E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.76
Albuquerque, NM E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.22
Albuquerque, NM E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $128.32
Albuquerque, NM E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.83
Albuquerque, NM E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $96.24
Albuquerque, NM E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.17
Albuquerque, NM E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.32
Albuquerque, NM E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.38
Albuquerque, NM E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.45
Albuquerque, NM E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.85
Albuquerque, NM E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.84
Albuquerque, NM E0156 SEAT ATTACHMENT, WALKER NU $13.55
Albuquerque, NM E0156 SEAT ATTACHMENT, WALKER RR $1.36
Albuquerque, NM E0156 SEAT ATTACHMENT, WALKER UE $10.16
Albuquerque, NM E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.00
Albuquerque, NM E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Albuquerque, NM E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.50
Albuquerque, NM E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.00
Albuquerque, NM E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.80
Albuquerque, NM E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.50
Albuquerque, NM E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Albuquerque, NM E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Albuquerque, NM E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Allentown-Bethlehem-Easton, PA-NJ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.56
Allentown-Bethlehem-Easton, PA-NJ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.26
Allentown-Bethlehem-Easton, PA-NJ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.92
Allentown-Bethlehem-Easton, PA-NJ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.88
Allentown-Bethlehem-Easton, PA-NJ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Allentown-Bethlehem-Easton, PA-NJ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.66
Allentown-Bethlehem-Easton, PA-NJ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $246.72
Allentown-Bethlehem-Easton, PA-NJ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.67
Allentown-Bethlehem-Easton, PA-NJ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $185.04
Allentown-Bethlehem-Easton, PA-NJ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.52
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 11 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Allentown-Bethlehem-Easton, PA-NJ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.55
Allentown-Bethlehem-Easton, PA-NJ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.14
Allentown-Bethlehem-Easton, PA-NJ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.00
Allentown-Bethlehem-Easton, PA-NJ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.10
Allentown-Bethlehem-Easton, PA-NJ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.25
Allentown-Bethlehem-Easton, PA-NJ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $367.86
Allentown-Bethlehem-Easton, PA-NJ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.79
Allentown-Bethlehem-Easton, PA-NJ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $275.90
Allentown-Bethlehem-Easton, PA-NJ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.68
Allentown-Bethlehem-Easton, PA-NJ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.87
Allentown-Bethlehem-Easton, PA-NJ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.01
Allentown-Bethlehem-Easton, PA-NJ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $114.78
Allentown-Bethlehem-Easton, PA-NJ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.48
Allentown-Bethlehem-Easton, PA-NJ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $86.09
Allentown-Bethlehem-Easton, PA-NJ E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.33
Allentown-Bethlehem-Easton, PA-NJ E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.03
Allentown-Bethlehem-Easton, PA-NJ E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.25
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 12 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Allentown-Bethlehem-Easton, PA-NJ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.37
Allentown-Bethlehem-Easton, PA-NJ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.74
Allentown-Bethlehem-Easton, PA-NJ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.03
Allentown-Bethlehem-Easton, PA-NJ E0156 SEAT ATTACHMENT, WALKER NU $14.18
Allentown-Bethlehem-Easton, PA-NJ E0156 SEAT ATTACHMENT, WALKER RR $1.42
Allentown-Bethlehem-Easton, PA-NJ E0156 SEAT ATTACHMENT, WALKER UE $10.64
Allentown-Bethlehem-Easton, PA-NJ E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.65
Allentown-Bethlehem-Easton, PA-NJ E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.67
Allentown-Bethlehem-Easton, PA-NJ E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.99
Allentown-Bethlehem-Easton, PA-NJ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.50
Allentown-Bethlehem-Easton, PA-NJ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.75
Allentown-Bethlehem-Easton, PA-NJ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.13
Allentown-Bethlehem-Easton, PA-NJ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.96
Allentown-Bethlehem-Easton, PA-NJ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Allentown-Bethlehem-Easton, PA-NJ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.72
Asheville, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.30
Asheville, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.73
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Asheville, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.48
Asheville, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.20
Asheville, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.92
Asheville, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.40
Asheville, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $262.86
Asheville, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.29
Asheville, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.15
Asheville, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $72.74
Asheville, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.27
Asheville, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $54.56
Asheville, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $45.98
Asheville, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.60
Asheville, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $34.49
Asheville, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $404.58
Asheville, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $40.46
Asheville, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $303.44
Asheville, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $79.30
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Asheville, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.93
Asheville, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.48
Asheville, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $98.81
Asheville, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.88
Asheville, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $74.11
Asheville, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.50
Asheville, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Asheville, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.63
Asheville, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.26
Asheville, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.83
Asheville, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.70
Asheville, NC E0156 SEAT ATTACHMENT, WALKER NU $15.25
Asheville, NC E0156 SEAT ATTACHMENT, WALKER RR $1.53
Asheville, NC E0156 SEAT ATTACHMENT, WALKER UE $11.44
Asheville, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $60.30
Asheville, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $6.03
Asheville, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $45.23
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 15 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Asheville, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.99
Asheville, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.00
Asheville, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.99
Asheville, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.22
Asheville, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.32
Asheville, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.92
Atlanta-Sandy Springs-Marietta, GA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.00
Atlanta-Sandy Springs-Marietta, GA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
Atlanta-Sandy Springs-Marietta, GA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.50
Atlanta-Sandy Springs-Marietta, GA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.98
Atlanta-Sandy Springs-Marietta, GA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
Atlanta-Sandy Springs-Marietta, GA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.49
Atlanta-Sandy Springs-Marietta, GA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $260.00
Atlanta-Sandy Springs-Marietta, GA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.00
Atlanta-Sandy Springs-Marietta, GA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $195.00
Atlanta-Sandy Springs-Marietta, GA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $74.27
Atlanta-Sandy Springs-Marietta, GA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.43
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Atlanta-Sandy Springs-Marietta, GA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $55.70
Atlanta-Sandy Springs-Marietta, GA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Atlanta-Sandy Springs-Marietta, GA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Atlanta-Sandy Springs-Marietta, GA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Atlanta-Sandy Springs-Marietta, GA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $383.15
Atlanta-Sandy Springs-Marietta, GA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.32
Atlanta-Sandy Springs-Marietta, GA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $287.36
Atlanta-Sandy Springs-Marietta, GA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $79.00
Atlanta-Sandy Springs-Marietta, GA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.90
Atlanta-Sandy Springs-Marietta, GA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.25
Atlanta-Sandy Springs-Marietta, GA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $123.98
Atlanta-Sandy Springs-Marietta, GA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.40
Atlanta-Sandy Springs-Marietta, GA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $92.99
Atlanta-Sandy Springs-Marietta, GA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Atlanta-Sandy Springs-Marietta, GA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Atlanta-Sandy Springs-Marietta, GA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
Atlanta-Sandy Springs-Marietta, GA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Atlanta-Sandy Springs-Marietta, GA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Atlanta-Sandy Springs-Marietta, GA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Atlanta-Sandy Springs-Marietta, GA E0156 SEAT ATTACHMENT, WALKER NU $15.10
Atlanta-Sandy Springs-Marietta, GA E0156 SEAT ATTACHMENT, WALKER RR $1.51
Atlanta-Sandy Springs-Marietta, GA E0156 SEAT ATTACHMENT, WALKER UE $11.33
Atlanta-Sandy Springs-Marietta, GA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.24
Atlanta-Sandy Springs-Marietta, GA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.02
Atlanta-Sandy Springs-Marietta, GA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.68
Atlanta-Sandy Springs-Marietta, GA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
Atlanta-Sandy Springs-Marietta, GA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Atlanta-Sandy Springs-Marietta, GA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Atlanta-Sandy Springs-Marietta, GA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.92
Atlanta-Sandy Springs-Marietta, GA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.29
Atlanta-Sandy Springs-Marietta, GA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.69
Augusta-Richmond County, GA-SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.00
Augusta-Richmond County, GA-SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
Augusta-Richmond County, GA-SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.50
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Augusta-Richmond County, GA-SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.98
Augusta-Richmond County, GA-SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.10
Augusta-Richmond County, GA-SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.74
Augusta-Richmond County, GA-SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $260.00
Augusta-Richmond County, GA-SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.00
Augusta-Richmond County, GA-SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $195.00
Augusta-Richmond County, GA-SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.00
Augusta-Richmond County, GA-SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.90
Augusta-Richmond County, GA-SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.75
Augusta-Richmond County, GA-SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.82
Augusta-Richmond County, GA-SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.38
Augusta-Richmond County, GA-SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.37
Augusta-Richmond County, GA-SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Augusta-Richmond County, GA-SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
Augusta-Richmond County, GA-SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Augusta-Richmond County, GA-SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.91
Augusta-Richmond County, GA-SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.89
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Augusta-Richmond County, GA-SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.18
Augusta-Richmond County, GA-SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.10
Augusta-Richmond County, GA-SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.51
Augusta-Richmond County, GA-SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.83
Augusta-Richmond County, GA-SC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.00
Augusta-Richmond County, GA-SC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
Augusta-Richmond County, GA-SC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.25
Augusta-Richmond County, GA-SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Augusta-Richmond County, GA-SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Augusta-Richmond County, GA-SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Augusta-Richmond County, GA-SC E0156 SEAT ATTACHMENT, WALKER NU $16.00
Augusta-Richmond County, GA-SC E0156 SEAT ATTACHMENT, WALKER RR $1.60
Augusta-Richmond County, GA-SC E0156 SEAT ATTACHMENT, WALKER UE $12.00
Augusta-Richmond County, GA-SC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.98
Augusta-Richmond County, GA-SC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
Augusta-Richmond County, GA-SC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.49
Augusta-Richmond County, GA-SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Augusta-Richmond County, GA-SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Augusta-Richmond County, GA-SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Augusta-Richmond County, GA-SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.92
Augusta-Richmond County, GA-SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.29
Augusta-Richmond County, GA-SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.69
Austin-Round Rock-San Marcos, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.50
Austin-Round Rock-San Marcos, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.25
Austin-Round Rock-San Marcos, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.88
Austin-Round Rock-San Marcos, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.00
Austin-Round Rock-San Marcos, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.90
Austin-Round Rock-San Marcos, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.25
Austin-Round Rock-San Marcos, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $255.22
Austin-Round Rock-San Marcos, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.52
Austin-Round Rock-San Marcos, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $191.42
Austin-Round Rock-San Marcos, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $64.55
Austin-Round Rock-San Marcos, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.46
Austin-Round Rock-San Marcos, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.41
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Austin-Round Rock-San Marcos, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $47.82
Austin-Round Rock-San Marcos, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.78
Austin-Round Rock-San Marcos, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $35.87
Austin-Round Rock-San Marcos, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.62
Austin-Round Rock-San Marcos, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.76
Austin-Round Rock-San Marcos, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.22
Austin-Round Rock-San Marcos, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $73.60
Austin-Round Rock-San Marcos, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.36
Austin-Round Rock-San Marcos, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $55.20
Austin-Round Rock-San Marcos, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $101.86
Austin-Round Rock-San Marcos, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.19
Austin-Round Rock-San Marcos, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $76.40
Austin-Round Rock-San Marcos, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.61
Austin-Round Rock-San Marcos, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.06
Austin-Round Rock-San Marcos, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.46
Austin-Round Rock-San Marcos, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.36
Austin-Round Rock-San Marcos, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.74
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 22 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Austin-Round Rock-San Marcos, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.02
Austin-Round Rock-San Marcos, TX E0156 SEAT ATTACHMENT, WALKER NU $13.11
Austin-Round Rock-San Marcos, TX E0156 SEAT ATTACHMENT, WALKER RR $1.31
Austin-Round Rock-San Marcos, TX E0156 SEAT ATTACHMENT, WALKER UE $9.83
Austin-Round Rock-San Marcos, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $47.18
Austin-Round Rock-San Marcos, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.72
Austin-Round Rock-San Marcos, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $35.39
Austin-Round Rock-San Marcos, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.12
Austin-Round Rock-San Marcos, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.81
Austin-Round Rock-San Marcos, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.59
Austin-Round Rock-San Marcos, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
Austin-Round Rock-San Marcos, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Austin-Round Rock-San Marcos, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
Bakersfield-Delano, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $51.06
Bakersfield-Delano, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $5.11
Bakersfield-Delano, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $38.30
Bakersfield-Delano, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.52
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 23 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Bakersfield-Delano, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.25
Bakersfield-Delano, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.89
Bakersfield-Delano, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $292.10
Bakersfield-Delano, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.21
Bakersfield-Delano, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $219.08
Bakersfield-Delano, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $73.50
Bakersfield-Delano, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.35
Bakersfield-Delano, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $55.13
Bakersfield-Delano, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.02
Bakersfield-Delano, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.30
Bakersfield-Delano, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.77
Bakersfield-Delano, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Bakersfield-Delano, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Bakersfield-Delano, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Bakersfield-Delano, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.30
Bakersfield-Delano, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.33
Bakersfield-Delano, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.48
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 24 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Bakersfield-Delano, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $116.75
Bakersfield-Delano, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.68
Bakersfield-Delano, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $87.56
Bakersfield-Delano, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.31
Bakersfield-Delano, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.33
Bakersfield-Delano, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.48
Bakersfield-Delano, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $19.64
Bakersfield-Delano, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.96
Bakersfield-Delano, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.73
Bakersfield-Delano, CA E0156 SEAT ATTACHMENT, WALKER NU $14.80
Bakersfield-Delano, CA E0156 SEAT ATTACHMENT, WALKER RR $1.48
Bakersfield-Delano, CA E0156 SEAT ATTACHMENT, WALKER UE $11.10
Bakersfield-Delano, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $57.48
Bakersfield-Delano, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.75
Bakersfield-Delano, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $43.11
Bakersfield-Delano, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.86
Bakersfield-Delano, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.99
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 25 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Bakersfield-Delano, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.90
Bakersfield-Delano, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
Bakersfield-Delano, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Bakersfield-Delano, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
Baltimore-Towson, MD E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.40
Baltimore-Towson, MD E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.64
Baltimore-Towson, MD E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.80
Baltimore-Towson, MD E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.18
Baltimore-Towson, MD E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.52
Baltimore-Towson, MD E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.89
Baltimore-Towson, MD E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $267.08
Baltimore-Towson, MD E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.71
Baltimore-Towson, MD E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $200.31
Baltimore-Towson, MD E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $70.25
Baltimore-Towson, MD E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.03
Baltimore-Towson, MD E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.69
Baltimore-Towson, MD E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $59.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 26 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Baltimore-Towson, MD E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.95
Baltimore-Towson, MD E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $44.63
Baltimore-Towson, MD E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Baltimore-Towson, MD E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Baltimore-Towson, MD E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Baltimore-Towson, MD E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.67
Baltimore-Towson, MD E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.27
Baltimore-Towson, MD E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.00
Baltimore-Towson, MD E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $129.52
Baltimore-Towson, MD E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.95
Baltimore-Towson, MD E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $97.14
Baltimore-Towson, MD E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.64
Baltimore-Towson, MD E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.26
Baltimore-Towson, MD E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.98
Baltimore-Towson, MD E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.69
Baltimore-Towson, MD E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.87
Baltimore-Towson, MD E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.02
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 27 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Baltimore-Towson, MD E0156 SEAT ATTACHMENT, WALKER NU $14.75
Baltimore-Towson, MD E0156 SEAT ATTACHMENT, WALKER RR $1.48
Baltimore-Towson, MD E0156 SEAT ATTACHMENT, WALKER UE $11.06
Baltimore-Towson, MD E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.56
Baltimore-Towson, MD E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.96
Baltimore-Towson, MD E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.17
Baltimore-Towson, MD E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.40
Baltimore-Towson, MD E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.94
Baltimore-Towson, MD E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.55
Baltimore-Towson, MD E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.95
Baltimore-Towson, MD E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Baltimore-Towson, MD E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.71
Baton Rouge, LA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.77
Baton Rouge, LA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.88
Baton Rouge, LA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.58
Baton Rouge, LA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.19
Baton Rouge, LA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.62
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 28 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Baton Rouge, LA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.64
Baton Rouge, LA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Baton Rouge, LA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Baton Rouge, LA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Baton Rouge, LA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $78.99
Baton Rouge, LA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.90
Baton Rouge, LA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $59.24
Baton Rouge, LA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
Baton Rouge, LA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
Baton Rouge, LA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
Baton Rouge, LA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $393.79
Baton Rouge, LA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $39.38
Baton Rouge, LA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $295.34
Baton Rouge, LA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.60
Baton Rouge, LA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.46
Baton Rouge, LA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.45
Baton Rouge, LA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $140.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Baton Rouge, LA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $14.00
Baton Rouge, LA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $105.00
Baton Rouge, LA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $48.31
Baton Rouge, LA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.83
Baton Rouge, LA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $36.23
Baton Rouge, LA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Baton Rouge, LA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Baton Rouge, LA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Baton Rouge, LA E0156 SEAT ATTACHMENT, WALKER NU $17.13
Baton Rouge, LA E0156 SEAT ATTACHMENT, WALKER RR $1.71
Baton Rouge, LA E0156 SEAT ATTACHMENT, WALKER UE $12.85
Baton Rouge, LA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $60.00
Baton Rouge, LA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $6.00
Baton Rouge, LA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $45.00
Baton Rouge, LA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.27
Baton Rouge, LA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.03
Baton Rouge, LA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.20
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 30 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Baton Rouge, LA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Baton Rouge, LA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Baton Rouge, LA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Beaumont-Port Arthur, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.82
Beaumont-Port Arthur, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.28
Beaumont-Port Arthur, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.12
Beaumont-Port Arthur, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.89
Beaumont-Port Arthur, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.89
Beaumont-Port Arthur, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.17
Beaumont-Port Arthur, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $276.86
Beaumont-Port Arthur, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $27.69
Beaumont-Port Arthur, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $207.65
Beaumont-Port Arthur, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $64.55
Beaumont-Port Arthur, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.46
Beaumont-Port Arthur, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.41
Beaumont-Port Arthur, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $47.82
Beaumont-Port Arthur, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.78
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 31 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Beaumont-Port Arthur, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $35.87
Beaumont-Port Arthur, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $361.64
Beaumont-Port Arthur, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.16
Beaumont-Port Arthur, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $271.23
Beaumont-Port Arthur, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $72.00
Beaumont-Port Arthur, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.20
Beaumont-Port Arthur, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $54.00
Beaumont-Port Arthur, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $99.96
Beaumont-Port Arthur, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.00
Beaumont-Port Arthur, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $74.97
Beaumont-Port Arthur, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.80
Beaumont-Port Arthur, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.98
Beaumont-Port Arthur, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.85
Beaumont-Port Arthur, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.36
Beaumont-Port Arthur, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.74
Beaumont-Port Arthur, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.02
Beaumont-Port Arthur, TX E0156 SEAT ATTACHMENT, WALKER NU $13.91
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 32 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Beaumont-Port Arthur, TX E0156 SEAT ATTACHMENT, WALKER RR $1.39
Beaumont-Port Arthur, TX E0156 SEAT ATTACHMENT, WALKER UE $10.43
Beaumont-Port Arthur, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.99
Beaumont-Port Arthur, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.90
Beaumont-Port Arthur, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.74
Beaumont-Port Arthur, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.70
Beaumont-Port Arthur, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.77
Beaumont-Port Arthur, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.28
Beaumont-Port Arthur, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.32
Beaumont-Port Arthur, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.23
Beaumont-Port Arthur, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.24
Birmingham-Hoover, AL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.28
Birmingham-Hoover, AL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.83
Birmingham-Hoover, AL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.21
Birmingham-Hoover, AL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.84
Birmingham-Hoover, AL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.48
Birmingham-Hoover, AL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.63
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 33 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Birmingham-Hoover, AL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $263.90
Birmingham-Hoover, AL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.39
Birmingham-Hoover, AL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.93
Birmingham-Hoover, AL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $78.06
Birmingham-Hoover, AL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.81
Birmingham-Hoover, AL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $58.55
Birmingham-Hoover, AL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.24
Birmingham-Hoover, AL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.52
Birmingham-Hoover, AL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.43
Birmingham-Hoover, AL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $392.22
Birmingham-Hoover, AL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $39.22
Birmingham-Hoover, AL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $294.17
Birmingham-Hoover, AL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.80
Birmingham-Hoover, AL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.28
Birmingham-Hoover, AL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.10
Birmingham-Hoover, AL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $126.61
Birmingham-Hoover, AL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.66
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 34 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Birmingham-Hoover, AL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.96
Birmingham-Hoover, AL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.94
Birmingham-Hoover, AL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.29
Birmingham-Hoover, AL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.21
Birmingham-Hoover, AL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $19.82
Birmingham-Hoover, AL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.98
Birmingham-Hoover, AL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.87
Birmingham-Hoover, AL E0156 SEAT ATTACHMENT, WALKER NU $15.42
Birmingham-Hoover, AL E0156 SEAT ATTACHMENT, WALKER RR $1.54
Birmingham-Hoover, AL E0156 SEAT ATTACHMENT, WALKER UE $11.57
Birmingham-Hoover, AL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $51.42
Birmingham-Hoover, AL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.14
Birmingham-Hoover, AL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $38.57
Birmingham-Hoover, AL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.86
Birmingham-Hoover, AL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.09
Birmingham-Hoover, AL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.65
Birmingham-Hoover, AL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.01
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 35 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Birmingham-Hoover, AL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Birmingham-Hoover, AL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.76
Boise City-Nampa, ID E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.82
Boise City-Nampa, ID E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.38
Boise City-Nampa, ID E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.87
Boise City-Nampa, ID E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
Boise City-Nampa, ID E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Boise City-Nampa, ID E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
Boise City-Nampa, ID E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Boise City-Nampa, ID E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Boise City-Nampa, ID E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Boise City-Nampa, ID E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.38
Boise City-Nampa, ID E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.94
Boise City-Nampa, ID E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.04
Boise City-Nampa, ID E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.04
Boise City-Nampa, ID E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.20
Boise City-Nampa, ID E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.03
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 36 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Boise City-Nampa, ID E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Boise City-Nampa, ID E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
Boise City-Nampa, ID E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Boise City-Nampa, ID E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.00
Boise City-Nampa, ID E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.20
Boise City-Nampa, ID E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.50
Boise City-Nampa, ID E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $115.58
Boise City-Nampa, ID E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.56
Boise City-Nampa, ID E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $86.69
Boise City-Nampa, ID E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.08
Boise City-Nampa, ID E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.31
Boise City-Nampa, ID E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.31
Boise City-Nampa, ID E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Boise City-Nampa, ID E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Boise City-Nampa, ID E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Boise City-Nampa, ID E0156 SEAT ATTACHMENT, WALKER NU $16.02
Boise City-Nampa, ID E0156 SEAT ATTACHMENT, WALKER RR $1.60
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 37 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Boise City-Nampa, ID E0156 SEAT ATTACHMENT, WALKER UE $12.02
Boise City-Nampa, ID E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.06
Boise City-Nampa, ID E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.01
Boise City-Nampa, ID E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.55
Boise City-Nampa, ID E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.66
Boise City-Nampa, ID E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Boise City-Nampa, ID E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.75
Boise City-Nampa, ID E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
Boise City-Nampa, ID E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
Boise City-Nampa, ID E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Boston-Cambridge-Quincy, MA-NH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.16
Boston-Cambridge-Quincy, MA-NH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.52
Boston-Cambridge-Quincy, MA-NH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.87
Boston-Cambridge-Quincy, MA-NH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.50
Boston-Cambridge-Quincy, MA-NH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.65
Boston-Cambridge-Quincy, MA-NH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.88
Boston-Cambridge-Quincy, MA-NH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $281.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 38 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Boston-Cambridge-Quincy, MA-NH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $28.10
Boston-Cambridge-Quincy, MA-NH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $210.75
Boston-Cambridge-Quincy, MA-NH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $76.00
Boston-Cambridge-Quincy, MA-NH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.60
Boston-Cambridge-Quincy, MA-NH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $57.00
Boston-Cambridge-Quincy, MA-NH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $58.24
Boston-Cambridge-Quincy, MA-NH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.82
Boston-Cambridge-Quincy, MA-NH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $43.68
Boston-Cambridge-Quincy, MA-NH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $386.90
Boston-Cambridge-Quincy, MA-NH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.69
Boston-Cambridge-Quincy, MA-NH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $290.18
Boston-Cambridge-Quincy, MA-NH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $81.00
Boston-Cambridge-Quincy, MA-NH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.10
Boston-Cambridge-Quincy, MA-NH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $60.75
Boston-Cambridge-Quincy, MA-NH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $127.04
Boston-Cambridge-Quincy, MA-NH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.70
Boston-Cambridge-Quincy, MA-NH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $95.28
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 39 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Boston-Cambridge-Quincy, MA-NH E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.27
Boston-Cambridge-Quincy, MA-NH E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.33
Boston-Cambridge-Quincy, MA-NH E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.45
Boston-Cambridge-Quincy, MA-NH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.56
Boston-Cambridge-Quincy, MA-NH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Boston-Cambridge-Quincy, MA-NH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.92
Boston-Cambridge-Quincy, MA-NH E0156 SEAT ATTACHMENT, WALKER NU $14.98
Boston-Cambridge-Quincy, MA-NH E0156 SEAT ATTACHMENT, WALKER RR $1.50
Boston-Cambridge-Quincy, MA-NH E0156 SEAT ATTACHMENT, WALKER UE $11.24
Boston-Cambridge-Quincy, MA-NH E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $58.06
Boston-Cambridge-Quincy, MA-NH E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.81
Boston-Cambridge-Quincy, MA-NH E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $43.55
Boston-Cambridge-Quincy, MA-NH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.76
Boston-Cambridge-Quincy, MA-NH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.98
Boston-Cambridge-Quincy, MA-NH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.82
Boston-Cambridge-Quincy, MA-NH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
Boston-Cambridge-Quincy, MA-NH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 40 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Boston-Cambridge-Quincy, MA-NH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
Bridgeport-Stamford-Norwalk, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.02
Bridgeport-Stamford-Norwalk, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.40
Bridgeport-Stamford-Norwalk, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.02
Bridgeport-Stamford-Norwalk, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.64
Bridgeport-Stamford-Norwalk, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.86
Bridgeport-Stamford-Norwalk, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $28.98
Bridgeport-Stamford-Norwalk, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $246.86
Bridgeport-Stamford-Norwalk, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.69
Bridgeport-Stamford-Norwalk, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $185.15
Bridgeport-Stamford-Norwalk, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $68.64
Bridgeport-Stamford-Norwalk, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.86
Bridgeport-Stamford-Norwalk, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.48
Bridgeport-Stamford-Norwalk, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $49.50
Bridgeport-Stamford-Norwalk, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.95
Bridgeport-Stamford-Norwalk, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.13
Bridgeport-Stamford-Norwalk, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 41 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Bridgeport-Stamford-Norwalk, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Bridgeport-Stamford-Norwalk, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Bridgeport-Stamford-Norwalk, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.46
Bridgeport-Stamford-Norwalk, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.75
Bridgeport-Stamford-Norwalk, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.10
Bridgeport-Stamford-Norwalk, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $101.62
Bridgeport-Stamford-Norwalk, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.16
Bridgeport-Stamford-Norwalk, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $76.22
Bridgeport-Stamford-Norwalk, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.48
Bridgeport-Stamford-Norwalk, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.05
Bridgeport-Stamford-Norwalk, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.36
Bridgeport-Stamford-Norwalk, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.32
Bridgeport-Stamford-Norwalk, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
Bridgeport-Stamford-Norwalk, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.99
Bridgeport-Stamford-Norwalk, CT E0156 SEAT ATTACHMENT, WALKER NU $15.30
Bridgeport-Stamford-Norwalk, CT E0156 SEAT ATTACHMENT, WALKER RR $1.53
Bridgeport-Stamford-Norwalk, CT E0156 SEAT ATTACHMENT, WALKER UE $11.48
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 42 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Bridgeport-Stamford-Norwalk, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $51.49
Bridgeport-Stamford-Norwalk, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.15
Bridgeport-Stamford-Norwalk, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $38.62
Bridgeport-Stamford-Norwalk, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.44
Bridgeport-Stamford-Norwalk, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.74
Bridgeport-Stamford-Norwalk, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.08
Bridgeport-Stamford-Norwalk, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.50
Bridgeport-Stamford-Norwalk, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.35
Bridgeport-Stamford-Norwalk, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.13
Bronx-Manhattan NY CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.00
Bronx-Manhattan NY CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
Bronx-Manhattan NY CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.50
Bronx-Manhattan NY CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.81
Bronx-Manhattan NY CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.88
Bronx-Manhattan NY CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.11
Bronx-Manhattan NY CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $220.50
Bronx-Manhattan NY CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $22.05
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 43 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Bronx-Manhattan NY CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $165.38
Bronx-Manhattan NY CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $63.51
Bronx-Manhattan NY CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.35
Bronx-Manhattan NY CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.63
Bronx-Manhattan NY CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $49.00
Bronx-Manhattan NY CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.90
Bronx-Manhattan NY CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $36.75
Bronx-Manhattan NY CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Bronx-Manhattan NY CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
Bronx-Manhattan NY CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Bronx-Manhattan NY CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $70.00
Bronx-Manhattan NY CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.00
Bronx-Manhattan NY CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $52.50
Bronx-Manhattan NY CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $99.92
Bronx-Manhattan NY CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.99
Bronx-Manhattan NY CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $74.94
Bronx-Manhattan NY CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 44 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Bronx-Manhattan NY CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Bronx-Manhattan NY CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Bronx-Manhattan NY CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.27
Bronx-Manhattan NY CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
Bronx-Manhattan NY CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.95
Bronx-Manhattan NY CBA E0156 SEAT ATTACHMENT, WALKER NU $14.00
Bronx-Manhattan NY CBA E0156 SEAT ATTACHMENT, WALKER RR $1.40
Bronx-Manhattan NY CBA E0156 SEAT ATTACHMENT, WALKER UE $10.50
Bronx-Manhattan NY CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.42
Bronx-Manhattan NY CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.64
Bronx-Manhattan NY CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.82
Bronx-Manhattan NY CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.00
Bronx-Manhattan NY CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.70
Bronx-Manhattan NY CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.75
Bronx-Manhattan NY CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
Bronx-Manhattan NY CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
Bronx-Manhattan NY CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 45 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Buffalo-Niagara Falls, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.29
Buffalo-Niagara Falls, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.13
Buffalo-Niagara Falls, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.97
Buffalo-Niagara Falls, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.00
Buffalo-Niagara Falls, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.00
Buffalo-Niagara Falls, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.00
Buffalo-Niagara Falls, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Buffalo-Niagara Falls, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Buffalo-Niagara Falls, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Buffalo-Niagara Falls, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $63.75
Buffalo-Niagara Falls, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.38
Buffalo-Niagara Falls, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.81
Buffalo-Niagara Falls, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
Buffalo-Niagara Falls, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
Buffalo-Niagara Falls, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
Buffalo-Niagara Falls, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Buffalo-Niagara Falls, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 46 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Buffalo-Niagara Falls, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Buffalo-Niagara Falls, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $74.85
Buffalo-Niagara Falls, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.49
Buffalo-Niagara Falls, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.14
Buffalo-Niagara Falls, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $101.19
Buffalo-Niagara Falls, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.12
Buffalo-Niagara Falls, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $75.89
Buffalo-Niagara Falls, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Buffalo-Niagara Falls, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Buffalo-Niagara Falls, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Buffalo-Niagara Falls, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.36
Buffalo-Niagara Falls, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.74
Buffalo-Niagara Falls, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.02
Buffalo-Niagara Falls, NY E0156 SEAT ATTACHMENT, WALKER NU $14.50
Buffalo-Niagara Falls, NY E0156 SEAT ATTACHMENT, WALKER RR $1.45
Buffalo-Niagara Falls, NY E0156 SEAT ATTACHMENT, WALKER UE $10.88
Buffalo-Niagara Falls, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.88
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 47 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Buffalo-Niagara Falls, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.69
Buffalo-Niagara Falls, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $35.16
Buffalo-Niagara Falls, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.16
Buffalo-Niagara Falls, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.72
Buffalo-Niagara Falls, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.87
Buffalo-Niagara Falls, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.92
Buffalo-Niagara Falls, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.29
Buffalo-Niagara Falls, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.69
Cape Coral-Fort Myers, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.00
Cape Coral-Fort Myers, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.00
Cape Coral-Fort Myers, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.00
Cape Coral-Fort Myers, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.47
Cape Coral-Fort Myers, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.35
Cape Coral-Fort Myers, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.60
Cape Coral-Fort Myers, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $220.25
Cape Coral-Fort Myers, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $22.03
Cape Coral-Fort Myers, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $165.19
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 48 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Cape Coral-Fort Myers, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $62.86
Cape Coral-Fort Myers, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.29
Cape Coral-Fort Myers, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.15
Cape Coral-Fort Myers, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.80
Cape Coral-Fort Myers, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.18
Cape Coral-Fort Myers, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.85
Cape Coral-Fort Myers, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $320.00
Cape Coral-Fort Myers, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $32.00
Cape Coral-Fort Myers, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $240.00
Cape Coral-Fort Myers, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $71.10
Cape Coral-Fort Myers, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.11
Cape Coral-Fort Myers, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $53.33
Cape Coral-Fort Myers, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.00
Cape Coral-Fort Myers, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.50
Cape Coral-Fort Myers, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.75
Cape Coral-Fort Myers, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.25
Cape Coral-Fort Myers, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.53
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 49 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Cape Coral-Fort Myers, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.44
Cape Coral-Fort Myers, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $16.12
Cape Coral-Fort Myers, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.61
Cape Coral-Fort Myers, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.09
Cape Coral-Fort Myers, FL E0156 SEAT ATTACHMENT, WALKER NU $12.58
Cape Coral-Fort Myers, FL E0156 SEAT ATTACHMENT, WALKER RR $1.26
Cape Coral-Fort Myers, FL E0156 SEAT ATTACHMENT, WALKER UE $9.44
Cape Coral-Fort Myers, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $40.50
Cape Coral-Fort Myers, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.05
Cape Coral-Fort Myers, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $30.38
Cape Coral-Fort Myers, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $16.16
Cape Coral-Fort Myers, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.62
Cape Coral-Fort Myers, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.12
Cape Coral-Fort Myers, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.44
Cape Coral-Fort Myers, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.14
Cape Coral-Fort Myers, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.58
Central-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.40
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 50 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Central-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.44
Central-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.30
Central-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.68
Central-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.77
Central-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.76
Central-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $252.22
Central-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.22
Central-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $189.17
Central-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.04
Central-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.90
Central-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.78
Central-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $60.21
Central-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.02
Central-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $45.16
Central-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $367.32
Central-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.73
Central-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $275.49
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 51 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Central-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.19
Central-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.22
Central-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.64
Central-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $136.66
Central-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.67
Central-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $102.50
Central-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.36
Central-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.24
Central-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.77
Central-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.12
Central-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.81
Central-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.59
Central-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER NU $14.00
Central-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER RR $1.40
Central-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER UE $10.50
Central-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.74
Central-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.07
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 52 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Central-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $38.06
Central-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.05
Central-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.91
Central-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.29
Central-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.36
Central-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.24
Central-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.27
Charleston-North Charleston-Summerville, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.41
Charleston-North Charleston-Summerville, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.54
Charleston-North Charleston-Summerville, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.06
Charleston-North Charleston-Summerville, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
Charleston-North Charleston-Summerville, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Charleston-North Charleston-Summerville, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
Charleston-North Charleston-Summerville, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $267.00
Charleston-North Charleston-Summerville, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.70
Charleston-North Charleston-Summerville, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $200.25
Charleston-North Charleston-Summerville, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 53 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Charleston-North Charleston-Summerville, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.90
Charleston-North Charleston-Summerville, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.75
Charleston-North Charleston-Summerville, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.04
Charleston-North Charleston-Summerville, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.20
Charleston-North Charleston-Summerville, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.03
Charleston-North Charleston-Summerville, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $393.79
Charleston-North Charleston-Summerville, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $39.38
Charleston-North Charleston-Summerville, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $295.34
Charleston-North Charleston-Summerville, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $79.00
Charleston-North Charleston-Summerville, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.90
Charleston-North Charleston-Summerville, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.25
Charleston-North Charleston-Summerville, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $110.00
Charleston-North Charleston-Summerville, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.00
Charleston-North Charleston-Summerville, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $82.50
Charleston-North Charleston-Summerville, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Charleston-North Charleston-Summerville, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Charleston-North Charleston-Summerville, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 54 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Charleston-North Charleston-Summerville, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Charleston-North Charleston-Summerville, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Charleston-North Charleston-Summerville, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Charleston-North Charleston-Summerville, SC E0156 SEAT ATTACHMENT, WALKER NU $16.00
Charleston-North Charleston-Summerville, SC E0156 SEAT ATTACHMENT, WALKER RR $1.60
Charleston-North Charleston-Summerville, SC E0156 SEAT ATTACHMENT, WALKER UE $12.00
Charleston-North Charleston-Summerville, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $60.00
Charleston-North Charleston-Summerville, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $6.00
Charleston-North Charleston-Summerville, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $45.00
Charleston-North Charleston-Summerville, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
Charleston-North Charleston-Summerville, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Charleston-North Charleston-Summerville, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Charleston-North Charleston-Summerville, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Charleston-North Charleston-Summerville, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Charleston-North Charleston-Summerville, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Chattanooga, TN-GA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.81
Chattanooga, TN-GA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.68
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 55 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Chattanooga, TN-GA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.11
Chattanooga, TN-GA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.10
Chattanooga, TN-GA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.11
Chattanooga, TN-GA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.83
Chattanooga, TN-GA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Chattanooga, TN-GA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Chattanooga, TN-GA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Chattanooga, TN-GA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.29
Chattanooga, TN-GA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.73
Chattanooga, TN-GA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.47
Chattanooga, TN-GA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
Chattanooga, TN-GA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
Chattanooga, TN-GA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
Chattanooga, TN-GA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Chattanooga, TN-GA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
Chattanooga, TN-GA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Chattanooga, TN-GA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.60
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 56 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Chattanooga, TN-GA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.46
Chattanooga, TN-GA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.45
Chattanooga, TN-GA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.10
Chattanooga, TN-GA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.51
Chattanooga, TN-GA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.83
Chattanooga, TN-GA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Chattanooga, TN-GA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Chattanooga, TN-GA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
Chattanooga, TN-GA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Chattanooga, TN-GA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Chattanooga, TN-GA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Chattanooga, TN-GA E0156 SEAT ATTACHMENT, WALKER NU $16.15
Chattanooga, TN-GA E0156 SEAT ATTACHMENT, WALKER RR $1.62
Chattanooga, TN-GA E0156 SEAT ATTACHMENT, WALKER UE $12.11
Chattanooga, TN-GA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.75
Chattanooga, TN-GA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.08
Chattanooga, TN-GA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $38.06
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 57 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Chattanooga, TN-GA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
Chattanooga, TN-GA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Chattanooga, TN-GA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Chattanooga, TN-GA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Chattanooga, TN-GA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Chattanooga, TN-GA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Colorado Springs, CO E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.32
Colorado Springs, CO E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.53
Colorado Springs, CO E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.99
Colorado Springs, CO E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.70
Colorado Springs, CO E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.97
Colorado Springs, CO E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.78
Colorado Springs, CO E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $249.58
Colorado Springs, CO E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.96
Colorado Springs, CO E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $187.19
Colorado Springs, CO E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $66.38
Colorado Springs, CO E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.64
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Colorado Springs, CO E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.79
Colorado Springs, CO E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.69
Colorado Springs, CO E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.27
Colorado Springs, CO E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.52
Colorado Springs, CO E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Colorado Springs, CO E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Colorado Springs, CO E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Colorado Springs, CO E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $79.81
Colorado Springs, CO E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.98
Colorado Springs, CO E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.86
Colorado Springs, CO E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $109.45
Colorado Springs, CO E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.95
Colorado Springs, CO E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $82.09
Colorado Springs, CO E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.80
Colorado Springs, CO E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.98
Colorado Springs, CO E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.85
Colorado Springs, CO E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.28
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Colorado Springs, CO E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.83
Colorado Springs, CO E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.71
Colorado Springs, CO E0156 SEAT ATTACHMENT, WALKER NU $14.12
Colorado Springs, CO E0156 SEAT ATTACHMENT, WALKER RR $1.41
Colorado Springs, CO E0156 SEAT ATTACHMENT, WALKER UE $10.59
Colorado Springs, CO E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $52.30
Colorado Springs, CO E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.23
Colorado Springs, CO E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.23
Colorado Springs, CO E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.31
Colorado Springs, CO E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.83
Colorado Springs, CO E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.73
Colorado Springs, CO E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.54
Colorado Springs, CO E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.25
Colorado Springs, CO E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.41
Columbia, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.13
Columbia, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.51
Columbia, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.85
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Columbia, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.98
Columbia, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.10
Columbia, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.74
Columbia, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Columbia, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Columbia, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Columbia, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.29
Columbia, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.73
Columbia, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.47
Columbia, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.14
Columbia, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.21
Columbia, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.11
Columbia, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Columbia, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
Columbia, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Columbia, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.62
Columbia, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.76
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Columbia, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.22
Columbia, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.10
Columbia, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.51
Columbia, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.83
Columbia, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Columbia, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Columbia, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
Columbia, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.02
Columbia, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.80
Columbia, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.52
Columbia, SC E0156 SEAT ATTACHMENT, WALKER NU $15.10
Columbia, SC E0156 SEAT ATTACHMENT, WALKER RR $1.51
Columbia, SC E0156 SEAT ATTACHMENT, WALKER UE $11.33
Columbia, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $56.13
Columbia, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.61
Columbia, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $42.10
Columbia, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.07
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Columbia, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.91
Columbia, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.30
Columbia, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
Columbia, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
Columbia, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Columbus, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.91
Columbus, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.29
Columbus, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.18
Columbus, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.39
Columbus, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.94
Columbus, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.54
Columbus, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $276.86
Columbus, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $27.69
Columbus, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $207.65
Columbus, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $61.62
Columbus, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.16
Columbus, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $46.22
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Columbus, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $44.48
Columbus, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.45
Columbus, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $33.36
Columbus, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $387.86
Columbus, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.79
Columbus, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $290.90
Columbus, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $69.72
Columbus, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $6.97
Columbus, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $52.29
Columbus, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $97.70
Columbus, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.77
Columbus, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $73.28
Columbus, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.80
Columbus, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.98
Columbus, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.85
Columbus, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.27
Columbus, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Columbus, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.95
Columbus, OH E0156 SEAT ATTACHMENT, WALKER NU $14.75
Columbus, OH E0156 SEAT ATTACHMENT, WALKER RR $1.48
Columbus, OH E0156 SEAT ATTACHMENT, WALKER UE $11.06
Columbus, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.20
Columbus, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.02
Columbus, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.65
Columbus, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.38
Columbus, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.74
Columbus, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.04
Columbus, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
Columbus, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Columbus, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
Dayton, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.82
Dayton, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.38
Dayton, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.87
Dayton, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.78
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Dayton, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.88
Dayton, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.09
Dayton, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Dayton, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Dayton, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Dayton, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $63.75
Dayton, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.38
Dayton, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.81
Dayton, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $43.97
Dayton, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.40
Dayton, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $32.98
Dayton, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $400.00
Dayton, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $40.00
Dayton, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $300.00
Dayton, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $70.00
Dayton, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.00
Dayton, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $52.50
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Dayton, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $95.47
Dayton, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.55
Dayton, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $71.60
Dayton, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Dayton, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Dayton, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Dayton, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.27
Dayton, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
Dayton, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.95
Dayton, OH E0156 SEAT ATTACHMENT, WALKER NU $15.00
Dayton, OH E0156 SEAT ATTACHMENT, WALKER RR $1.50
Dayton, OH E0156 SEAT ATTACHMENT, WALKER UE $11.25
Dayton, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.42
Dayton, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.04
Dayton, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.82
Dayton, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.61
Dayton, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.76
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 67 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Dayton, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.21
Dayton, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Dayton, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Dayton, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Deltona-Daytona Beach-Ormond Beach, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.00
Deltona-Daytona Beach-Ormond Beach, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.00
Deltona-Daytona Beach-Ormond Beach, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.00
Deltona-Daytona Beach-Ormond Beach, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.69
Deltona-Daytona Beach-Ormond Beach, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.27
Deltona-Daytona Beach-Ormond Beach, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.02
Deltona-Daytona Beach-Ormond Beach, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $239.87
Deltona-Daytona Beach-Ormond Beach, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.99
Deltona-Daytona Beach-Ormond Beach, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $179.90
Deltona-Daytona Beach-Ormond Beach, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $62.00
Deltona-Daytona Beach-Ormond Beach, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.20
Deltona-Daytona Beach-Ormond Beach, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $46.50
Deltona-Daytona Beach-Ormond Beach, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.60
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 68 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Deltona-Daytona Beach-Ormond Beach, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.16
Deltona-Daytona Beach-Ormond Beach, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.70
Deltona-Daytona Beach-Ormond Beach, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $325.00
Deltona-Daytona Beach-Ormond Beach, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $32.50
Deltona-Daytona Beach-Ormond Beach, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $243.75
Deltona-Daytona Beach-Ormond Beach, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $75.00
Deltona-Daytona Beach-Ormond Beach, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.50
Deltona-Daytona Beach-Ormond Beach, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.25
Deltona-Daytona Beach-Ormond Beach, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $120.00
Deltona-Daytona Beach-Ormond Beach, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.00
Deltona-Daytona Beach-Ormond Beach, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $90.00
Deltona-Daytona Beach-Ormond Beach, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.50
Deltona-Daytona Beach-Ormond Beach, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.55
Deltona-Daytona Beach-Ormond Beach, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.63
Deltona-Daytona Beach-Ormond Beach, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $16.00
Deltona-Daytona Beach-Ormond Beach, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.60
Deltona-Daytona Beach-Ormond Beach, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 69 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Deltona-Daytona Beach-Ormond Beach, FL E0156 SEAT ATTACHMENT, WALKER NU $13.00
Deltona-Daytona Beach-Ormond Beach, FL E0156 SEAT ATTACHMENT, WALKER RR $1.30
Deltona-Daytona Beach-Ormond Beach, FL E0156 SEAT ATTACHMENT, WALKER UE $9.75
Deltona-Daytona Beach-Ormond Beach, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $41.00
Deltona-Daytona Beach-Ormond Beach, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.10
Deltona-Daytona Beach-Ormond Beach, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $30.75
Deltona-Daytona Beach-Ormond Beach, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $16.00
Deltona-Daytona Beach-Ormond Beach, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.60
Deltona-Daytona Beach-Ormond Beach, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.00
Deltona-Daytona Beach-Ormond Beach, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.88
Deltona-Daytona Beach-Ormond Beach, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.19
Deltona-Daytona Beach-Ormond Beach, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.91
Denver-Aurora-Broomfield, CO E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.66
Denver-Aurora-Broomfield, CO E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.37
Denver-Aurora-Broomfield, CO E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.75
Denver-Aurora-Broomfield, CO E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.12
Denver-Aurora-Broomfield, CO E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.01
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Denver-Aurora-Broomfield, CO E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.09
Denver-Aurora-Broomfield, CO E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $239.22
Denver-Aurora-Broomfield, CO E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.92
Denver-Aurora-Broomfield, CO E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $179.42
Denver-Aurora-Broomfield, CO E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $66.38
Denver-Aurora-Broomfield, CO E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.64
Denver-Aurora-Broomfield, CO E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.79
Denver-Aurora-Broomfield, CO E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $54.17
Denver-Aurora-Broomfield, CO E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.42
Denver-Aurora-Broomfield, CO E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.63
Denver-Aurora-Broomfield, CO E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $360.81
Denver-Aurora-Broomfield, CO E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.08
Denver-Aurora-Broomfield, CO E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $270.61
Denver-Aurora-Broomfield, CO E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $79.81
Denver-Aurora-Broomfield, CO E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.98
Denver-Aurora-Broomfield, CO E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.86
Denver-Aurora-Broomfield, CO E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $120.34
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 71 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Denver-Aurora-Broomfield, CO E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.03
Denver-Aurora-Broomfield, CO E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $90.26
Denver-Aurora-Broomfield, CO E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.50
Denver-Aurora-Broomfield, CO E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.15
Denver-Aurora-Broomfield, CO E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.13
Denver-Aurora-Broomfield, CO E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.28
Denver-Aurora-Broomfield, CO E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.83
Denver-Aurora-Broomfield, CO E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.71
Denver-Aurora-Broomfield, CO E0156 SEAT ATTACHMENT, WALKER NU $14.25
Denver-Aurora-Broomfield, CO E0156 SEAT ATTACHMENT, WALKER RR $1.43
Denver-Aurora-Broomfield, CO E0156 SEAT ATTACHMENT, WALKER UE $10.69
Denver-Aurora-Broomfield, CO E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.64
Denver-Aurora-Broomfield, CO E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.96
Denver-Aurora-Broomfield, CO E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.23
Denver-Aurora-Broomfield, CO E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.80
Denver-Aurora-Broomfield, CO E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.88
Denver-Aurora-Broomfield, CO E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.10
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 72 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Denver-Aurora-Broomfield, CO E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.14
Denver-Aurora-Broomfield, CO E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.21
Denver-Aurora-Broomfield, CO E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.11
Detroit-Warren-Livonia, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.50
Detroit-Warren-Livonia, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.55
Detroit-Warren-Livonia, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.13
Detroit-Warren-Livonia, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.16
Detroit-Warren-Livonia, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.52
Detroit-Warren-Livonia, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.87
Detroit-Warren-Livonia, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $259.36
Detroit-Warren-Livonia, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.94
Detroit-Warren-Livonia, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.52
Detroit-Warren-Livonia, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $75.00
Detroit-Warren-Livonia, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.50
Detroit-Warren-Livonia, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $56.25
Detroit-Warren-Livonia, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.48
Detroit-Warren-Livonia, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.65
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 73 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Detroit-Warren-Livonia, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.36
Detroit-Warren-Livonia, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $381.58
Detroit-Warren-Livonia, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.16
Detroit-Warren-Livonia, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $286.19
Detroit-Warren-Livonia, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.30
Detroit-Warren-Livonia, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.33
Detroit-Warren-Livonia, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.48
Detroit-Warren-Livonia, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $128.21
Detroit-Warren-Livonia, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.82
Detroit-Warren-Livonia, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $96.16
Detroit-Warren-Livonia, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.00
Detroit-Warren-Livonia, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.20
Detroit-Warren-Livonia, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.50
Detroit-Warren-Livonia, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.88
Detroit-Warren-Livonia, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.79
Detroit-Warren-Livonia, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.41
Detroit-Warren-Livonia, MI E0156 SEAT ATTACHMENT, WALKER NU $14.92
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Detroit-Warren-Livonia, MI E0156 SEAT ATTACHMENT, WALKER RR $1.49
Detroit-Warren-Livonia, MI E0156 SEAT ATTACHMENT, WALKER UE $11.19
Detroit-Warren-Livonia, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $52.30
Detroit-Warren-Livonia, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.23
Detroit-Warren-Livonia, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.23
Detroit-Warren-Livonia, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.50
Detroit-Warren-Livonia, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.85
Detroit-Warren-Livonia, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.88
Detroit-Warren-Livonia, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Detroit-Warren-Livonia, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Detroit-Warren-Livonia, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
El Paso, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.50
El Paso, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.35
El Paso, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.63
El Paso, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.54
El Paso, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.35
El Paso, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.66
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
El Paso, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $253.86
El Paso, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.39
El Paso, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $190.40
El Paso, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.38
El Paso, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.74
El Paso, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.54
El Paso, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.40
El Paso, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.24
El Paso, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.30
El Paso, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.62
El Paso, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.76
El Paso, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.22
El Paso, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $79.81
El Paso, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.98
El Paso, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.86
El Paso, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.88
El Paso, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.59
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
El Paso, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.41
El Paso, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.58
El Paso, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.36
El Paso, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.69
El Paso, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.54
El Paso, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.85
El Paso, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.91
El Paso, TX E0156 SEAT ATTACHMENT, WALKER NU $13.95
El Paso, TX E0156 SEAT ATTACHMENT, WALKER RR $1.40
El Paso, TX E0156 SEAT ATTACHMENT, WALKER UE $10.46
El Paso, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.08
El Paso, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.91
El Paso, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.81
El Paso, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.28
El Paso, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.93
El Paso, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.46
El Paso, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
El Paso, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
El Paso, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
Flint, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.13
Flint, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.71
Flint, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.35
Flint, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
Flint, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Flint, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
Flint, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Flint, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Flint, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Flint, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.07
Flint, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.51
Flint, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.80
Flint, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.04
Flint, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.20
Flint, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.03
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 78 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Flint, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Flint, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
Flint, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Flint, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.98
Flint, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.90
Flint, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.24
Flint, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $120.00
Flint, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.00
Flint, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $90.00
Flint, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Flint, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Flint, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Flint, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.00
Flint, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.80
Flint, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.50
Flint, MI E0156 SEAT ATTACHMENT, WALKER NU $15.10
Flint, MI E0156 SEAT ATTACHMENT, WALKER RR $1.51
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 79 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Flint, MI E0156 SEAT ATTACHMENT, WALKER UE $11.33
Flint, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $55.28
Flint, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.53
Flint, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $41.46
Flint, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
Flint, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Flint, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Flint, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Flint, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Flint, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Fresno, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.13
Fresno, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.71
Fresno, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.35
Fresno, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.47
Fresno, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.35
Fresno, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.60
Fresno, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 80 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Fresno, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Fresno, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Fresno, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.97
Fresno, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.00
Fresno, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.48
Fresno, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.00
Fresno, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.60
Fresno, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.00
Fresno, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $351.22
Fresno, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $35.12
Fresno, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $263.42
Fresno, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.00
Fresno, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.20
Fresno, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.50
Fresno, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $118.48
Fresno, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.85
Fresno, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $88.86
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Fresno, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.00
Fresno, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.20
Fresno, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.50
Fresno, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $19.20
Fresno, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.92
Fresno, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.40
Fresno, CA E0156 SEAT ATTACHMENT, WALKER NU $14.69
Fresno, CA E0156 SEAT ATTACHMENT, WALKER RR $1.47
Fresno, CA E0156 SEAT ATTACHMENT, WALKER UE $11.02
Fresno, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.98
Fresno, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
Fresno, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.49
Fresno, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.66
Fresno, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Fresno, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.75
Fresno, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.36
Fresno, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.24
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 82 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Fresno, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.27
Grand Rapids-Wyoming, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $50.00
Grand Rapids-Wyoming, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $5.00
Grand Rapids-Wyoming, MI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $37.50
Grand Rapids-Wyoming, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.62
Grand Rapids-Wyoming, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.26
Grand Rapids-Wyoming, MI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.97
Grand Rapids-Wyoming, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $281.00
Grand Rapids-Wyoming, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $28.10
Grand Rapids-Wyoming, MI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $210.75
Grand Rapids-Wyoming, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $73.50
Grand Rapids-Wyoming, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.35
Grand Rapids-Wyoming, MI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $55.13
Grand Rapids-Wyoming, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.02
Grand Rapids-Wyoming, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.30
Grand Rapids-Wyoming, MI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.77
Grand Rapids-Wyoming, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $413.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 83 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Grand Rapids-Wyoming, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $41.30
Grand Rapids-Wyoming, MI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $309.75
Grand Rapids-Wyoming, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.99
Grand Rapids-Wyoming, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.90
Grand Rapids-Wyoming, MI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.24
Grand Rapids-Wyoming, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $121.99
Grand Rapids-Wyoming, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.20
Grand Rapids-Wyoming, MI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $91.49
Grand Rapids-Wyoming, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.77
Grand Rapids-Wyoming, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.28
Grand Rapids-Wyoming, MI E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.08
Grand Rapids-Wyoming, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.88
Grand Rapids-Wyoming, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.79
Grand Rapids-Wyoming, MI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.41
Grand Rapids-Wyoming, MI E0156 SEAT ATTACHMENT, WALKER NU $15.05
Grand Rapids-Wyoming, MI E0156 SEAT ATTACHMENT, WALKER RR $1.51
Grand Rapids-Wyoming, MI E0156 SEAT ATTACHMENT, WALKER UE $11.29
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 84 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Grand Rapids-Wyoming, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $57.64
Grand Rapids-Wyoming, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.76
Grand Rapids-Wyoming, MI E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $43.23
Grand Rapids-Wyoming, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.02
Grand Rapids-Wyoming, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.00
Grand Rapids-Wyoming, MI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.02
Grand Rapids-Wyoming, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.25
Grand Rapids-Wyoming, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.33
Grand Rapids-Wyoming, MI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.94
Greensboro-High Point, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.56
Greensboro-High Point, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.66
Greensboro-High Point, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.92
Greensboro-High Point, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.31
Greensboro-High Point, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.83
Greensboro-High Point, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.23
Greensboro-High Point, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $262.86
Greensboro-High Point, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.29
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 85 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Greensboro-High Point, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.15
Greensboro-High Point, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $76.12
Greensboro-High Point, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.61
Greensboro-High Point, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $57.09
Greensboro-High Point, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.24
Greensboro-High Point, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.52
Greensboro-High Point, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.43
Greensboro-High Point, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $386.90
Greensboro-High Point, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.69
Greensboro-High Point, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $290.18
Greensboro-High Point, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.28
Greensboro-High Point, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.23
Greensboro-High Point, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.71
Greensboro-High Point, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $132.18
Greensboro-High Point, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.22
Greensboro-High Point, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $99.14
Greensboro-High Point, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.56
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 86 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Greensboro-High Point, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.06
Greensboro-High Point, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.42
Greensboro-High Point, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.59
Greensboro-High Point, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Greensboro-High Point, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.94
Greensboro-High Point, NC E0156 SEAT ATTACHMENT, WALKER NU $15.32
Greensboro-High Point, NC E0156 SEAT ATTACHMENT, WALKER RR $1.53
Greensboro-High Point, NC E0156 SEAT ATTACHMENT, WALKER UE $11.49
Greensboro-High Point, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $58.06
Greensboro-High Point, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.81
Greensboro-High Point, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $43.55
Greensboro-High Point, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.78
Greensboro-High Point, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.08
Greensboro-High Point, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.59
Greensboro-High Point, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $14.39
Greensboro-High Point, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.44
Greensboro-High Point, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.79
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 87 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Greenville-Mauldin-Easley, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.35
Greenville-Mauldin-Easley, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.44
Greenville-Mauldin-Easley, SC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.26
Greenville-Mauldin-Easley, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.10
Greenville-Mauldin-Easley, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.11
Greenville-Mauldin-Easley, SC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.83
Greenville-Mauldin-Easley, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Greenville-Mauldin-Easley, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Greenville-Mauldin-Easley, SC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Greenville-Mauldin-Easley, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $66.55
Greenville-Mauldin-Easley, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.66
Greenville-Mauldin-Easley, SC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.91
Greenville-Mauldin-Easley, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.82
Greenville-Mauldin-Easley, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.38
Greenville-Mauldin-Easley, SC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.37
Greenville-Mauldin-Easley, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Greenville-Mauldin-Easley, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 88 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Greenville-Mauldin-Easley, SC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Greenville-Mauldin-Easley, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.23
Greenville-Mauldin-Easley, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.22
Greenville-Mauldin-Easley, SC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.67
Greenville-Mauldin-Easley, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $131.11
Greenville-Mauldin-Easley, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.11
Greenville-Mauldin-Easley, SC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $98.33
Greenville-Mauldin-Easley, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $46.25
Greenville-Mauldin-Easley, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.63
Greenville-Mauldin-Easley, SC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $34.69
Greenville-Mauldin-Easley, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.74
Greenville-Mauldin-Easley, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.87
Greenville-Mauldin-Easley, SC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.06
Greenville-Mauldin-Easley, SC E0156 SEAT ATTACHMENT, WALKER NU $16.00
Greenville-Mauldin-Easley, SC E0156 SEAT ATTACHMENT, WALKER RR $1.60
Greenville-Mauldin-Easley, SC E0156 SEAT ATTACHMENT, WALKER UE $12.00
Greenville-Mauldin-Easley, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $59.92
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 89 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Greenville-Mauldin-Easley, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.99
Greenville-Mauldin-Easley, SC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $44.94
Greenville-Mauldin-Easley, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.01
Greenville-Mauldin-Easley, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.00
Greenville-Mauldin-Easley, SC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.01
Greenville-Mauldin-Easley, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.40
Greenville-Mauldin-Easley, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.34
Greenville-Mauldin-Easley, SC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.05
Hartford-West Hartford-East Hartford, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.74
Hartford-West Hartford-East Hartford, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.37
Hartford-West Hartford-East Hartford, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.81
Hartford-West Hartford-East Hartford, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.53
Hartford-West Hartford-East Hartford, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.95
Hartford-West Hartford-East Hartford, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.65
Hartford-West Hartford-East Hartford, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $257.92
Hartford-West Hartford-East Hartford, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.79
Hartford-West Hartford-East Hartford, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $193.44
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 90 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Hartford-West Hartford-East Hartford, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.30
Hartford-West Hartford-East Hartford, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.93
Hartford-West Hartford-East Hartford, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.98
Hartford-West Hartford-East Hartford, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.50
Hartford-West Hartford-East Hartford, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.35
Hartford-West Hartford-East Hartford, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.13
Hartford-West Hartford-East Hartford, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Hartford-West Hartford-East Hartford, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Hartford-West Hartford-East Hartford, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Hartford-West Hartford-East Hartford, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $81.00
Hartford-West Hartford-East Hartford, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.10
Hartford-West Hartford-East Hartford, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $60.75
Hartford-West Hartford-East Hartford, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $103.32
Hartford-West Hartford-East Hartford, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.33
Hartford-West Hartford-East Hartford, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $77.49
Hartford-West Hartford-East Hartford, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.98
Hartford-West Hartford-East Hartford, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 91 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Hartford-West Hartford-East Hartford, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.24
Hartford-West Hartford-East Hartford, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.52
Hartford-West Hartford-East Hartford, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.85
Hartford-West Hartford-East Hartford, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.89
Hartford-West Hartford-East Hartford, CT E0156 SEAT ATTACHMENT, WALKER NU $14.75
Hartford-West Hartford-East Hartford, CT E0156 SEAT ATTACHMENT, WALKER RR $1.48
Hartford-West Hartford-East Hartford, CT E0156 SEAT ATTACHMENT, WALKER UE $11.06
Hartford-West Hartford-East Hartford, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $53.82
Hartford-West Hartford-East Hartford, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.38
Hartford-West Hartford-East Hartford, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $40.37
Hartford-West Hartford-East Hartford, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.24
Hartford-West Hartford-East Hartford, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.92
Hartford-West Hartford-East Hartford, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.43
Hartford-West Hartford-East Hartford, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.61
Hartford-West Hartford-East Hartford, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.26
Hartford-West Hartford-East Hartford, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.46
Honolulu, HI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.75
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 92 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Honolulu, HI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.88
Honolulu, HI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.56
Honolulu, HI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.00
Honolulu, HI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.80
Honolulu, HI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.00
Honolulu, HI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $247.06
Honolulu, HI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.71
Honolulu, HI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $185.30
Honolulu, HI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $76.62
Honolulu, HI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.66
Honolulu, HI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $57.47
Honolulu, HI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.00
Honolulu, HI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.50
Honolulu, HI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.75
Honolulu, HI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $383.15
Honolulu, HI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.32
Honolulu, HI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $287.36
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Honolulu, HI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $76.23
Honolulu, HI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.62
Honolulu, HI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $57.17
Honolulu, HI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $135.00
Honolulu, HI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.50
Honolulu, HI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $101.25
Honolulu, HI E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $44.00
Honolulu, HI E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.40
Honolulu, HI E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $33.00
Honolulu, HI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $20.79
Honolulu, HI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $2.08
Honolulu, HI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $15.59
Honolulu, HI E0156 SEAT ATTACHMENT, WALKER NU $15.50
Honolulu, HI E0156 SEAT ATTACHMENT, WALKER RR $1.55
Honolulu, HI E0156 SEAT ATTACHMENT, WALKER UE $11.63
Honolulu, HI E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.28
Honolulu, HI E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.83
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 94 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Honolulu, HI E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.21
Honolulu, HI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.25
Honolulu, HI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.83
Honolulu, HI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.69
Honolulu, HI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.75
Honolulu, HI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Honolulu, HI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.56
Houston-Sugar Land-Baytown, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.82
Houston-Sugar Land-Baytown, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.18
Houston-Sugar Land-Baytown, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.37
Houston-Sugar Land-Baytown, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
Houston-Sugar Land-Baytown, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Houston-Sugar Land-Baytown, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
Houston-Sugar Land-Baytown, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $259.00
Houston-Sugar Land-Baytown, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.90
Houston-Sugar Land-Baytown, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.25
Houston-Sugar Land-Baytown, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.11
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Houston-Sugar Land-Baytown, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.51
Houston-Sugar Land-Baytown, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.83
Houston-Sugar Land-Baytown, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.37
Houston-Sugar Land-Baytown, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.24
Houston-Sugar Land-Baytown, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.28
Houston-Sugar Land-Baytown, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Houston-Sugar Land-Baytown, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
Houston-Sugar Land-Baytown, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Houston-Sugar Land-Baytown, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $76.60
Houston-Sugar Land-Baytown, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.66
Houston-Sugar Land-Baytown, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $57.45
Houston-Sugar Land-Baytown, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $120.00
Houston-Sugar Land-Baytown, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.00
Houston-Sugar Land-Baytown, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $90.00
Houston-Sugar Land-Baytown, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.22
Houston-Sugar Land-Baytown, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.12
Houston-Sugar Land-Baytown, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.92
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Houston-Sugar Land-Baytown, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.06
Houston-Sugar Land-Baytown, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.81
Houston-Sugar Land-Baytown, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.55
Houston-Sugar Land-Baytown, TX E0156 SEAT ATTACHMENT, WALKER NU $13.32
Houston-Sugar Land-Baytown, TX E0156 SEAT ATTACHMENT, WALKER RR $1.33
Houston-Sugar Land-Baytown, TX E0156 SEAT ATTACHMENT, WALKER UE $9.99
Houston-Sugar Land-Baytown, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.47
Houston-Sugar Land-Baytown, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.65
Houston-Sugar Land-Baytown, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.85
Houston-Sugar Land-Baytown, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.23
Houston-Sugar Land-Baytown, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.82
Houston-Sugar Land-Baytown, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.67
Houston-Sugar Land-Baytown, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.38
Houston-Sugar Land-Baytown, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.24
Houston-Sugar Land-Baytown, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.29
Huntington-Ashland, WV-KY-OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.82
Huntington-Ashland, WV-KY-OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.38
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Huntington-Ashland, WV-KY-OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.87
Huntington-Ashland, WV-KY-OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.01
Huntington-Ashland, WV-KY-OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.90
Huntington-Ashland, WV-KY-OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.26
Huntington-Ashland, WV-KY-OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Huntington-Ashland, WV-KY-OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Huntington-Ashland, WV-KY-OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Huntington-Ashland, WV-KY-OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.33
Huntington-Ashland, WV-KY-OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.53
Huntington-Ashland, WV-KY-OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.00
Huntington-Ashland, WV-KY-OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $49.00
Huntington-Ashland, WV-KY-OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.90
Huntington-Ashland, WV-KY-OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $36.75
Huntington-Ashland, WV-KY-OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $383.15
Huntington-Ashland, WV-KY-OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.32
Huntington-Ashland, WV-KY-OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $287.36
Huntington-Ashland, WV-KY-OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $75.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Huntington-Ashland, WV-KY-OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.50
Huntington-Ashland, WV-KY-OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.25
Huntington-Ashland, WV-KY-OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $99.92
Huntington-Ashland, WV-KY-OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.99
Huntington-Ashland, WV-KY-OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $74.94
Huntington-Ashland, WV-KY-OH E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.95
Huntington-Ashland, WV-KY-OH E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Huntington-Ashland, WV-KY-OH E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.96
Huntington-Ashland, WV-KY-OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.27
Huntington-Ashland, WV-KY-OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
Huntington-Ashland, WV-KY-OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.95
Huntington-Ashland, WV-KY-OH E0156 SEAT ATTACHMENT, WALKER NU $14.50
Huntington-Ashland, WV-KY-OH E0156 SEAT ATTACHMENT, WALKER RR $1.45
Huntington-Ashland, WV-KY-OH E0156 SEAT ATTACHMENT, WALKER UE $10.88
Huntington-Ashland, WV-KY-OH E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.00
Huntington-Ashland, WV-KY-OH E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.80
Huntington-Ashland, WV-KY-OH E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Huntington-Ashland, WV-KY-OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.06
Huntington-Ashland, WV-KY-OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.71
Huntington-Ashland, WV-KY-OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.80
Huntington-Ashland, WV-KY-OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.00
Huntington-Ashland, WV-KY-OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.20
Huntington-Ashland, WV-KY-OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.00
Indiana-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.98
Indiana-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
Indiana-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.49
Indiana-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.93
Indiana-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Indiana-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.70
Indiana-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $266.00
Indiana-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.60
Indiana-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $199.50
Indiana-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $74.26
Indiana-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.43
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Indiana-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $55.70
Indiana-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Indiana-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Indiana-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Indiana-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Indiana-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Indiana-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Indiana-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.00
Indiana-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.30
Indiana-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.25
Indiana-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $132.50
Indiana-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.25
Indiana-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $99.38
Indiana-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.11
Indiana-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.31
Indiana-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.33
Indiana-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.56
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Indiana-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Indiana-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.92
Indiana-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER NU $15.55
Indiana-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER RR $1.56
Indiana-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER UE $11.66
Indiana-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $53.04
Indiana-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.30
Indiana-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.78
Indiana-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.00
Indiana-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.90
Indiana-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.25
Indiana-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.98
Indiana-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Indiana-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.74
Indianapolis-Carmel, IN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.00
Indianapolis-Carmel, IN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
Indianapolis-Carmel, IN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.50
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Indianapolis-Carmel, IN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
Indianapolis-Carmel, IN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Indianapolis-Carmel, IN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
Indianapolis-Carmel, IN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Indianapolis-Carmel, IN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Indianapolis-Carmel, IN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Indianapolis-Carmel, IN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.29
Indianapolis-Carmel, IN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.73
Indianapolis-Carmel, IN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.47
Indianapolis-Carmel, IN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
Indianapolis-Carmel, IN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
Indianapolis-Carmel, IN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
Indianapolis-Carmel, IN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $400.00
Indianapolis-Carmel, IN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $40.00
Indianapolis-Carmel, IN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $300.00
Indianapolis-Carmel, IN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.62
Indianapolis-Carmel, IN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.76
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 103 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Indianapolis-Carmel, IN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.22
Indianapolis-Carmel, IN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $100.00
Indianapolis-Carmel, IN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.00
Indianapolis-Carmel, IN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $75.00
Indianapolis-Carmel, IN E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $44.94
Indianapolis-Carmel, IN E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.49
Indianapolis-Carmel, IN E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $33.71
Indianapolis-Carmel, IN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.94
Indianapolis-Carmel, IN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.79
Indianapolis-Carmel, IN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.46
Indianapolis-Carmel, IN E0156 SEAT ATTACHMENT, WALKER NU $15.10
Indianapolis-Carmel, IN E0156 SEAT ATTACHMENT, WALKER RR $1.51
Indianapolis-Carmel, IN E0156 SEAT ATTACHMENT, WALKER UE $11.33
Indianapolis-Carmel, IN E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.42
Indianapolis-Carmel, IN E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.04
Indianapolis-Carmel, IN E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.82
Indianapolis-Carmel, IN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.61
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 104 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Indianapolis-Carmel, IN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.76
Indianapolis-Carmel, IN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.21
Indianapolis-Carmel, IN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Indianapolis-Carmel, IN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Indianapolis-Carmel, IN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Jackson, MS E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.56
Jackson, MS E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.66
Jackson, MS E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.92
Jackson, MS E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.29
Jackson, MS E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.53
Jackson, MS E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.97
Jackson, MS E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $271.00
Jackson, MS E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $27.10
Jackson, MS E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $203.25
Jackson, MS E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $71.14
Jackson, MS E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.11
Jackson, MS E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $53.36
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 105 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Jackson, MS E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.50
Jackson, MS E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.25
Jackson, MS E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.38
Jackson, MS E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $402.22
Jackson, MS E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $40.22
Jackson, MS E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $301.67
Jackson, MS E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.80
Jackson, MS E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.38
Jackson, MS E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.85
Jackson, MS E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $126.61
Jackson, MS E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.66
Jackson, MS E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.96
Jackson, MS E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $44.27
Jackson, MS E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.43
Jackson, MS E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $33.20
Jackson, MS E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.75
Jackson, MS E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.88
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 106 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Jackson, MS E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.06
Jackson, MS E0156 SEAT ATTACHMENT, WALKER NU $15.05
Jackson, MS E0156 SEAT ATTACHMENT, WALKER RR $1.51
Jackson, MS E0156 SEAT ATTACHMENT, WALKER UE $11.29
Jackson, MS E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $52.49
Jackson, MS E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.25
Jackson, MS E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.37
Jackson, MS E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.48
Jackson, MS E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.95
Jackson, MS E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.61
Jackson, MS E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
Jackson, MS E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Jackson, MS E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
Jacksonville, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.04
Jacksonville, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.00
Jacksonville, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.03
Jacksonville, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.69
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 107 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Jacksonville, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.27
Jacksonville, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.02
Jacksonville, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $234.00
Jacksonville, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.40
Jacksonville, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $175.50
Jacksonville, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $62.00
Jacksonville, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.20
Jacksonville, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $46.50
Jacksonville, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.60
Jacksonville, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.16
Jacksonville, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.70
Jacksonville, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $315.00
Jacksonville, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $31.50
Jacksonville, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $236.25
Jacksonville, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $75.00
Jacksonville, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.50
Jacksonville, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.25
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 108 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Jacksonville, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.00
Jacksonville, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.50
Jacksonville, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.75
Jacksonville, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.50
Jacksonville, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.55
Jacksonville, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.63
Jacksonville, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $15.78
Jacksonville, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.58
Jacksonville, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $11.84
Jacksonville, FL E0156 SEAT ATTACHMENT, WALKER NU $12.87
Jacksonville, FL E0156 SEAT ATTACHMENT, WALKER RR $1.29
Jacksonville, FL E0156 SEAT ATTACHMENT, WALKER UE $9.65
Jacksonville, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $44.81
Jacksonville, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.48
Jacksonville, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $33.61
Jacksonville, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.00
Jacksonville, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.70
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 109 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Jacksonville, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.75
Jacksonville, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.88
Jacksonville, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.19
Jacksonville, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.91
Knoxville, TN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.60
Knoxville, TN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.56
Knoxville, TN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.20
Knoxville, TN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.10
Knoxville, TN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.11
Knoxville, TN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.83
Knoxville, TN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Knoxville, TN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Knoxville, TN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Knoxville, TN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.47
Knoxville, TN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.55
Knoxville, TN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.10
Knoxville, TN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 110 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Knoxville, TN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Knoxville, TN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Knoxville, TN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $383.15
Knoxville, TN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.32
Knoxville, TN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $287.36
Knoxville, TN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.00
Knoxville, TN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.20
Knoxville, TN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.50
Knoxville, TN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.10
Knoxville, TN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.51
Knoxville, TN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.83
Knoxville, TN E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Knoxville, TN E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Knoxville, TN E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
Knoxville, TN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.01
Knoxville, TN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.80
Knoxville, TN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.51
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Knoxville, TN E0156 SEAT ATTACHMENT, WALKER NU $15.10
Knoxville, TN E0156 SEAT ATTACHMENT, WALKER RR $1.51
Knoxville, TN E0156 SEAT ATTACHMENT, WALKER UE $11.33
Knoxville, TN E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $57.60
Knoxville, TN E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.76
Knoxville, TN E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $43.20
Knoxville, TN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
Knoxville, TN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Knoxville, TN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Knoxville, TN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Knoxville, TN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Knoxville, TN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Lakeland-Winter Haven, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.14
Lakeland-Winter Haven, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.01
Lakeland-Winter Haven, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.11
Lakeland-Winter Haven, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.00
Lakeland-Winter Haven, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 112 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Lakeland-Winter Haven, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.75
Lakeland-Winter Haven, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $239.87
Lakeland-Winter Haven, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.99
Lakeland-Winter Haven, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $179.90
Lakeland-Winter Haven, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $64.90
Lakeland-Winter Haven, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.49
Lakeland-Winter Haven, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.68
Lakeland-Winter Haven, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.71
Lakeland-Winter Haven, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.07
Lakeland-Winter Haven, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.03
Lakeland-Winter Haven, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $345.00
Lakeland-Winter Haven, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $34.50
Lakeland-Winter Haven, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $258.75
Lakeland-Winter Haven, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.00
Lakeland-Winter Haven, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.80
Lakeland-Winter Haven, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.50
Lakeland-Winter Haven, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.32
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 113 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Lakeland-Winter Haven, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.53
Lakeland-Winter Haven, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.99
Lakeland-Winter Haven, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.75
Lakeland-Winter Haven, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.58
Lakeland-Winter Haven, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.81
Lakeland-Winter Haven, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $16.12
Lakeland-Winter Haven, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.61
Lakeland-Winter Haven, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.09
Lakeland-Winter Haven, FL E0156 SEAT ATTACHMENT, WALKER NU $14.00
Lakeland-Winter Haven, FL E0156 SEAT ATTACHMENT, WALKER RR $1.40
Lakeland-Winter Haven, FL E0156 SEAT ATTACHMENT, WALKER UE $10.50
Lakeland-Winter Haven, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.30
Lakeland-Winter Haven, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.63
Lakeland-Winter Haven, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.73
Lakeland-Winter Haven, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $16.66
Lakeland-Winter Haven, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.67
Lakeland-Winter Haven, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 114 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Lakeland-Winter Haven, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.88
Lakeland-Winter Haven, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.19
Lakeland-Winter Haven, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.91
Las Vegas-Paradise, NV E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.00
Las Vegas-Paradise, NV E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.40
Las Vegas-Paradise, NV E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.00
Las Vegas-Paradise, NV E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.44
Las Vegas-Paradise, NV E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.24
Las Vegas-Paradise, NV E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.83
Las Vegas-Paradise, NV E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $240.00
Las Vegas-Paradise, NV E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.00
Las Vegas-Paradise, NV E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $180.00
Las Vegas-Paradise, NV E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.38
Las Vegas-Paradise, NV E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.94
Las Vegas-Paradise, NV E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.04
Las Vegas-Paradise, NV E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Las Vegas-Paradise, NV E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 115 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Las Vegas-Paradise, NV E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Las Vegas-Paradise, NV E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $345.90
Las Vegas-Paradise, NV E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $34.59
Las Vegas-Paradise, NV E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $259.43
Las Vegas-Paradise, NV E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.62
Las Vegas-Paradise, NV E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.76
Las Vegas-Paradise, NV E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.22
Las Vegas-Paradise, NV E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $128.32
Las Vegas-Paradise, NV E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.83
Las Vegas-Paradise, NV E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $96.24
Las Vegas-Paradise, NV E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.00
Las Vegas-Paradise, NV E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
Las Vegas-Paradise, NV E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.25
Las Vegas-Paradise, NV E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.94
Las Vegas-Paradise, NV E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.79
Las Vegas-Paradise, NV E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.46
Las Vegas-Paradise, NV E0156 SEAT ATTACHMENT, WALKER NU $14.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 116 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Las Vegas-Paradise, NV E0156 SEAT ATTACHMENT, WALKER RR $1.40
Las Vegas-Paradise, NV E0156 SEAT ATTACHMENT, WALKER UE $10.50
Las Vegas-Paradise, NV E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.30
Las Vegas-Paradise, NV E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.93
Las Vegas-Paradise, NV E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.98
Las Vegas-Paradise, NV E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.25
Las Vegas-Paradise, NV E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.83
Las Vegas-Paradise, NV E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.69
Las Vegas-Paradise, NV E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.00
Las Vegas-Paradise, NV E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.20
Las Vegas-Paradise, NV E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.00
Little Rock-North Little Rock-Conway, AR E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.91
Little Rock-North Little Rock-Conway, AR E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Little Rock-North Little Rock-Conway, AR E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.68
Little Rock-North Little Rock-Conway, AR E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.90
Little Rock-North Little Rock-Conway, AR E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.89
Little Rock-North Little Rock-Conway, AR E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.18
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Little Rock-North Little Rock-Conway, AR E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $262.86
Little Rock-North Little Rock-Conway, AR E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.29
Little Rock-North Little Rock-Conway, AR E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.15
Little Rock-North Little Rock-Conway, AR E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.96
Little Rock-North Little Rock-Conway, AR E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.80
Little Rock-North Little Rock-Conway, AR E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.97
Little Rock-North Little Rock-Conway, AR E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $46.50
Little Rock-North Little Rock-Conway, AR E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.65
Little Rock-North Little Rock-Conway, AR E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $34.88
Little Rock-North Little Rock-Conway, AR E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $390.00
Little Rock-North Little Rock-Conway, AR E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $39.00
Little Rock-North Little Rock-Conway, AR E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $292.50
Little Rock-North Little Rock-Conway, AR E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $70.00
Little Rock-North Little Rock-Conway, AR E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.00
Little Rock-North Little Rock-Conway, AR E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $52.50
Little Rock-North Little Rock-Conway, AR E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $99.96
Little Rock-North Little Rock-Conway, AR E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Little Rock-North Little Rock-Conway, AR E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $74.97
Little Rock-North Little Rock-Conway, AR E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.80
Little Rock-North Little Rock-Conway, AR E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.98
Little Rock-North Little Rock-Conway, AR E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.85
Little Rock-North Little Rock-Conway, AR E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $16.14
Little Rock-North Little Rock-Conway, AR E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.61
Little Rock-North Little Rock-Conway, AR E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.11
Little Rock-North Little Rock-Conway, AR E0156 SEAT ATTACHMENT, WALKER NU $14.80
Little Rock-North Little Rock-Conway, AR E0156 SEAT ATTACHMENT, WALKER RR $1.48
Little Rock-North Little Rock-Conway, AR E0156 SEAT ATTACHMENT, WALKER UE $11.10
Little Rock-North Little Rock-Conway, AR E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.99
Little Rock-North Little Rock-Conway, AR E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.90
Little Rock-North Little Rock-Conway, AR E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.74
Little Rock-North Little Rock-Conway, AR E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.10
Little Rock-North Little Rock-Conway, AR E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.71
Little Rock-North Little Rock-Conway, AR E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.83
Little Rock-North Little Rock-Conway, AR E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.38
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Little Rock-North Little Rock-Conway, AR E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.34
Little Rock-North Little Rock-Conway, AR E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.04
Los Angeles County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.86
Los Angeles County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Los Angeles County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.65
Los Angeles County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.47
Los Angeles County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.35
Los Angeles County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.60
Los Angeles County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $240.44
Los Angeles County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.04
Los Angeles County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $180.33
Los Angeles County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.84
Los Angeles County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.98
Los Angeles County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.38
Los Angeles County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.91
Los Angeles County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.79
Los Angeles County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $43.43
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Los Angeles County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $333.00
Los Angeles County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $33.30
Los Angeles County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $249.75
Los Angeles County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $74.52
Los Angeles County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.45
Los Angeles County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $55.89
Los Angeles County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $123.60
Los Angeles County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.36
Los Angeles County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $92.70
Los Angeles County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Los Angeles County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Los Angeles County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Los Angeles County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.50
Los Angeles County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.85
Los Angeles County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.88
Los Angeles County CBA E0156 SEAT ATTACHMENT, WALKER NU $14.68
Los Angeles County CBA E0156 SEAT ATTACHMENT, WALKER RR $1.47
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Los Angeles County CBA E0156 SEAT ATTACHMENT, WALKER UE $11.01
Los Angeles County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $44.48
Los Angeles County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.45
Los Angeles County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $33.36
Los Angeles County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.50
Los Angeles County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.85
Los Angeles County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.88
Los Angeles County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.00
Los Angeles County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.20
Los Angeles County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.00
Louisville/Jefferson County, KY-IN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.44
Louisville/Jefferson County, KY-IN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.84
Louisville/Jefferson County, KY-IN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.33
Louisville/Jefferson County, KY-IN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.63
Louisville/Jefferson County, KY-IN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.96
Louisville/Jefferson County, KY-IN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.72
Louisville/Jefferson County, KY-IN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Louisville/Jefferson County, KY-IN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Louisville/Jefferson County, KY-IN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Louisville/Jefferson County, KY-IN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $71.14
Louisville/Jefferson County, KY-IN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.11
Louisville/Jefferson County, KY-IN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $53.36
Louisville/Jefferson County, KY-IN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $48.50
Louisville/Jefferson County, KY-IN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.85
Louisville/Jefferson County, KY-IN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $36.38
Louisville/Jefferson County, KY-IN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $425.50
Louisville/Jefferson County, KY-IN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $42.55
Louisville/Jefferson County, KY-IN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $319.13
Louisville/Jefferson County, KY-IN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.50
Louisville/Jefferson County, KY-IN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.75
Louisville/Jefferson County, KY-IN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.13
Louisville/Jefferson County, KY-IN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $101.51
Louisville/Jefferson County, KY-IN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.15
Louisville/Jefferson County, KY-IN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $76.13
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Louisville/Jefferson County, KY-IN E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $46.97
Louisville/Jefferson County, KY-IN E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.70
Louisville/Jefferson County, KY-IN E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $35.23
Louisville/Jefferson County, KY-IN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.64
Louisville/Jefferson County, KY-IN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.76
Louisville/Jefferson County, KY-IN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.23
Louisville/Jefferson County, KY-IN E0156 SEAT ATTACHMENT, WALKER NU $15.28
Louisville/Jefferson County, KY-IN E0156 SEAT ATTACHMENT, WALKER RR $1.53
Louisville/Jefferson County, KY-IN E0156 SEAT ATTACHMENT, WALKER UE $11.46
Louisville/Jefferson County, KY-IN E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $54.71
Louisville/Jefferson County, KY-IN E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.47
Louisville/Jefferson County, KY-IN E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $41.03
Louisville/Jefferson County, KY-IN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.36
Louisville/Jefferson County, KY-IN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.94
Louisville/Jefferson County, KY-IN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.52
Louisville/Jefferson County, KY-IN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Louisville/Jefferson County, KY-IN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Louisville/Jefferson County, KY-IN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
McAllen-Edinburg-Mission, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.19
McAllen-Edinburg-Mission, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.32
McAllen-Edinburg-Mission, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.39
McAllen-Edinburg-Mission, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.01
McAllen-Edinburg-Mission, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
McAllen-Edinburg-Mission, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.51
McAllen-Edinburg-Mission, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $259.92
McAllen-Edinburg-Mission, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.99
McAllen-Edinburg-Mission, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.94
McAllen-Edinburg-Mission, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $66.01
McAllen-Edinburg-Mission, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.60
McAllen-Edinburg-Mission, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.51
McAllen-Edinburg-Mission, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
McAllen-Edinburg-Mission, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
McAllen-Edinburg-Mission, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
McAllen-Edinburg-Mission, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
McAllen-Edinburg-Mission, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
McAllen-Edinburg-Mission, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
McAllen-Edinburg-Mission, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.21
McAllen-Edinburg-Mission, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.82
McAllen-Edinburg-Mission, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.66
McAllen-Edinburg-Mission, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $119.70
McAllen-Edinburg-Mission, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.97
McAllen-Edinburg-Mission, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $89.78
McAllen-Edinburg-Mission, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.02
McAllen-Edinburg-Mission, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.10
McAllen-Edinburg-Mission, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.77
McAllen-Edinburg-Mission, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
McAllen-Edinburg-Mission, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
McAllen-Edinburg-Mission, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
McAllen-Edinburg-Mission, TX E0156 SEAT ATTACHMENT, WALKER NU $13.55
McAllen-Edinburg-Mission, TX E0156 SEAT ATTACHMENT, WALKER RR $1.36
McAllen-Edinburg-Mission, TX E0156 SEAT ATTACHMENT, WALKER UE $10.16
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
McAllen-Edinburg-Mission, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.19
McAllen-Edinburg-Mission, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.82
McAllen-Edinburg-Mission, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.14
McAllen-Edinburg-Mission, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.00
McAllen-Edinburg-Mission, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.80
McAllen-Edinburg-Mission, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.50
McAllen-Edinburg-Mission, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
McAllen-Edinburg-Mission, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
McAllen-Edinburg-Mission, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Memphis, TN-MS-AR E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.66
Memphis, TN-MS-AR E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.37
Memphis, TN-MS-AR E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.75
Memphis, TN-MS-AR E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.29
Memphis, TN-MS-AR E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.53
Memphis, TN-MS-AR E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.97
Memphis, TN-MS-AR E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $276.86
Memphis, TN-MS-AR E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $27.69
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Memphis, TN-MS-AR E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $207.65
Memphis, TN-MS-AR E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.40
Memphis, TN-MS-AR E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.54
Memphis, TN-MS-AR E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.05
Memphis, TN-MS-AR E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.34
Memphis, TN-MS-AR E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.53
Memphis, TN-MS-AR E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.51
Memphis, TN-MS-AR E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Memphis, TN-MS-AR E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Memphis, TN-MS-AR E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Memphis, TN-MS-AR E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.80
Memphis, TN-MS-AR E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.38
Memphis, TN-MS-AR E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.85
Memphis, TN-MS-AR E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $126.61
Memphis, TN-MS-AR E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.66
Memphis, TN-MS-AR E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.96
Memphis, TN-MS-AR E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.27
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 128 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Memphis, TN-MS-AR E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.33
Memphis, TN-MS-AR E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.45
Memphis, TN-MS-AR E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.98
Memphis, TN-MS-AR E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.80
Memphis, TN-MS-AR E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.49
Memphis, TN-MS-AR E0156 SEAT ATTACHMENT, WALKER NU $14.78
Memphis, TN-MS-AR E0156 SEAT ATTACHMENT, WALKER RR $1.48
Memphis, TN-MS-AR E0156 SEAT ATTACHMENT, WALKER UE $11.09
Memphis, TN-MS-AR E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $52.68
Memphis, TN-MS-AR E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.27
Memphis, TN-MS-AR E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.51
Memphis, TN-MS-AR E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.24
Memphis, TN-MS-AR E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.82
Memphis, TN-MS-AR E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.68
Memphis, TN-MS-AR E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
Memphis, TN-MS-AR E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Memphis, TN-MS-AR E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 129 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Milwaukee-Waukesha-West Allis, WI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.87
Milwaukee-Waukesha-West Allis, WI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.79
Milwaukee-Waukesha-West Allis, WI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.90
Milwaukee-Waukesha-West Allis, WI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.06
Milwaukee-Waukesha-West Allis, WI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.81
Milwaukee-Waukesha-West Allis, WI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.05
Milwaukee-Waukesha-West Allis, WI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $297.50
Milwaukee-Waukesha-West Allis, WI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.75
Milwaukee-Waukesha-West Allis, WI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $223.13
Milwaukee-Waukesha-West Allis, WI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $73.00
Milwaukee-Waukesha-West Allis, WI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.30
Milwaukee-Waukesha-West Allis, WI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $54.75
Milwaukee-Waukesha-West Allis, WI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $54.72
Milwaukee-Waukesha-West Allis, WI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.47
Milwaukee-Waukesha-West Allis, WI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.04
Milwaukee-Waukesha-West Allis, WI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $402.22
Milwaukee-Waukesha-West Allis, WI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $40.22
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 130 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Milwaukee-Waukesha-West Allis, WI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $301.67
Milwaukee-Waukesha-West Allis, WI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $87.93
Milwaukee-Waukesha-West Allis, WI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.79
Milwaukee-Waukesha-West Allis, WI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $65.95
Milwaukee-Waukesha-West Allis, WI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $137.62
Milwaukee-Waukesha-West Allis, WI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.76
Milwaukee-Waukesha-West Allis, WI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $103.22
Milwaukee-Waukesha-West Allis, WI E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $48.50
Milwaukee-Waukesha-West Allis, WI E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.85
Milwaukee-Waukesha-West Allis, WI E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $36.38
Milwaukee-Waukesha-West Allis, WI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $22.10
Milwaukee-Waukesha-West Allis, WI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $2.21
Milwaukee-Waukesha-West Allis, WI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $16.58
Milwaukee-Waukesha-West Allis, WI E0156 SEAT ATTACHMENT, WALKER NU $15.70
Milwaukee-Waukesha-West Allis, WI E0156 SEAT ATTACHMENT, WALKER RR $1.57
Milwaukee-Waukesha-West Allis, WI E0156 SEAT ATTACHMENT, WALKER UE $11.78
Milwaukee-Waukesha-West Allis, WI E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $60.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 131 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Milwaukee-Waukesha-West Allis, WI E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $6.05
Milwaukee-Waukesha-West Allis, WI E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $45.38
Milwaukee-Waukesha-West Allis, WI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $21.90
Milwaukee-Waukesha-West Allis, WI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.19
Milwaukee-Waukesha-West Allis, WI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $16.43
Milwaukee-Waukesha-West Allis, WI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.48
Milwaukee-Waukesha-West Allis, WI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.35
Milwaukee-Waukesha-West Allis, WI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.11
Minneapolis-St. Paul-Bloomington, MN-WI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.56
Minneapolis-St. Paul-Bloomington, MN-WI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.66
Minneapolis-St. Paul-Bloomington, MN-WI E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.92
Minneapolis-St. Paul-Bloomington, MN-WI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.90
Minneapolis-St. Paul-Bloomington, MN-WI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.69
Minneapolis-St. Paul-Bloomington, MN-WI E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.18
Minneapolis-St. Paul-Bloomington, MN-WI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $281.00
Minneapolis-St. Paul-Bloomington, MN-WI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $28.10
Minneapolis-St. Paul-Bloomington, MN-WI E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $210.75
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 132 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Minneapolis-St. Paul-Bloomington, MN-WI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $72.66
Minneapolis-St. Paul-Bloomington, MN-WI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.27
Minneapolis-St. Paul-Bloomington, MN-WI E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $54.50
Minneapolis-St. Paul-Bloomington, MN-WI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.52
Minneapolis-St. Paul-Bloomington, MN-WI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.35
Minneapolis-St. Paul-Bloomington, MN-WI E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.14
Minneapolis-St. Paul-Bloomington, MN-WI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $399.50
Minneapolis-St. Paul-Bloomington, MN-WI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $39.95
Minneapolis-St. Paul-Bloomington, MN-WI E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $299.63
Minneapolis-St. Paul-Bloomington, MN-WI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.64
Minneapolis-St. Paul-Bloomington, MN-WI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.46
Minneapolis-St. Paul-Bloomington, MN-WI E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.48
Minneapolis-St. Paul-Bloomington, MN-WI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $135.00
Minneapolis-St. Paul-Bloomington, MN-WI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.50
Minneapolis-St. Paul-Bloomington, MN-WI E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $101.25
Minneapolis-St. Paul-Bloomington, MN-WI E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.77
Minneapolis-St. Paul-Bloomington, MN-WI E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.38
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 133 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Minneapolis-St. Paul-Bloomington, MN-WI E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.83
Minneapolis-St. Paul-Bloomington, MN-WI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $20.90
Minneapolis-St. Paul-Bloomington, MN-WI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $2.09
Minneapolis-St. Paul-Bloomington, MN-WI E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $15.68
Minneapolis-St. Paul-Bloomington, MN-WI E0156 SEAT ATTACHMENT, WALKER NU $15.30
Minneapolis-St. Paul-Bloomington, MN-WI E0156 SEAT ATTACHMENT, WALKER RR $1.53
Minneapolis-St. Paul-Bloomington, MN-WI E0156 SEAT ATTACHMENT, WALKER UE $11.48
Minneapolis-St. Paul-Bloomington, MN-WI E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $57.30
Minneapolis-St. Paul-Bloomington, MN-WI E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.73
Minneapolis-St. Paul-Bloomington, MN-WI E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $42.98
Minneapolis-St. Paul-Bloomington, MN-WI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.99
Minneapolis-St. Paul-Bloomington, MN-WI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.00
Minneapolis-St. Paul-Bloomington, MN-WI E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.99
Minneapolis-St. Paul-Bloomington, MN-WI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Minneapolis-St. Paul-Bloomington, MN-WI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Minneapolis-St. Paul-Bloomington, MN-WI E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Nashville-Davidson--Murfreesboro--Franklin, TN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.79
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 134 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Nashville-Davidson--Murfreesboro--Franklin, TN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.38
Nashville-Davidson--Murfreesboro--Franklin, TN E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.84
Nashville-Davidson--Murfreesboro--Franklin, TN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.70
Nashville-Davidson--Murfreesboro--Franklin, TN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.47
Nashville-Davidson--Murfreesboro--Franklin, TN E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.53
Nashville-Davidson--Murfreesboro--Franklin, TN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $279.40
Nashville-Davidson--Murfreesboro--Franklin, TN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $27.94
Nashville-Davidson--Murfreesboro--Franklin, TN E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $209.55
Nashville-Davidson--Murfreesboro--Franklin, TN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.40
Nashville-Davidson--Murfreesboro--Franklin, TN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.54
Nashville-Davidson--Murfreesboro--Franklin, TN E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.05
Nashville-Davidson--Murfreesboro--Franklin, TN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.71
Nashville-Davidson--Murfreesboro--Franklin, TN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.67
Nashville-Davidson--Murfreesboro--Franklin, TN E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.53
Nashville-Davidson--Murfreesboro--Franklin, TN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $381.58
Nashville-Davidson--Murfreesboro--Franklin, TN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.16
Nashville-Davidson--Murfreesboro--Franklin, TN E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $286.19
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 135 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Nashville-Davidson--Murfreesboro--Franklin, TN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.50
Nashville-Davidson--Murfreesboro--Franklin, TN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.35
Nashville-Davidson--Murfreesboro--Franklin, TN E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.63
Nashville-Davidson--Murfreesboro--Franklin, TN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $137.00
Nashville-Davidson--Murfreesboro--Franklin, TN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.70
Nashville-Davidson--Murfreesboro--Franklin, TN E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $102.75
Nashville-Davidson--Murfreesboro--Franklin, TN E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.44
Nashville-Davidson--Murfreesboro--Franklin, TN E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.34
Nashville-Davidson--Murfreesboro--Franklin, TN E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.58
Nashville-Davidson--Murfreesboro--Franklin, TN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.98
Nashville-Davidson--Murfreesboro--Franklin, TN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.80
Nashville-Davidson--Murfreesboro--Franklin, TN E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.49
Nashville-Davidson--Murfreesboro--Franklin, TN E0156 SEAT ATTACHMENT, WALKER NU $14.94
Nashville-Davidson--Murfreesboro--Franklin, TN E0156 SEAT ATTACHMENT, WALKER RR $1.49
Nashville-Davidson--Murfreesboro--Franklin, TN E0156 SEAT ATTACHMENT, WALKER UE $11.21
Nashville-Davidson--Murfreesboro--Franklin, TN E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $52.68
Nashville-Davidson--Murfreesboro--Franklin, TN E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.27
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 136 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Nashville-Davidson--Murfreesboro--Franklin, TN E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.51
Nashville-Davidson--Murfreesboro--Franklin, TN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.98
Nashville-Davidson--Murfreesboro--Franklin, TN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.90
Nashville-Davidson--Murfreesboro--Franklin, TN E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.24
Nashville-Davidson--Murfreesboro--Franklin, TN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Nashville-Davidson--Murfreesboro--Franklin, TN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Nashville-Davidson--Murfreesboro--Franklin, TN E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.75
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.28
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.06
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.93
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.70
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $236.36
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.64
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $177.27
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $63.63
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 137 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.36
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.72
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $368.75
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.88
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $276.56
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $74.86
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.49
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.15
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $123.04
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.30
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $92.28
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 138 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.32
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.99
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0156 SEAT ATTACHMENT, WALKER NU $15.00
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0156 SEAT ATTACHMENT, WALKER RR $1.50
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0156 SEAT ATTACHMENT, WALKER UE $11.25
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.24
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.62
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.68
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.16
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.72
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.87
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.28
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.23
Nassau-Brooklyn-Queens-Richmond County Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.21
New Haven-Milford, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.48
New Haven-Milford, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.55
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 139 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
New Haven-Milford, CT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.11
New Haven-Milford, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.53
New Haven-Milford, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.95
New Haven-Milford, CT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.65
New Haven-Milford, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $276.86
New Haven-Milford, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $27.69
New Haven-Milford, CT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $207.65
New Haven-Milford, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.44
New Haven-Milford, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.74
New Haven-Milford, CT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.58
New Haven-Milford, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.50
New Haven-Milford, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.35
New Haven-Milford, CT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.13
New Haven-Milford, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
New Haven-Milford, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
New Haven-Milford, CT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
New Haven-Milford, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.30
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
New Haven-Milford, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.33
New Haven-Milford, CT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.48
New Haven-Milford, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $103.32
New Haven-Milford, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.33
New Haven-Milford, CT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $77.49
New Haven-Milford, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.98
New Haven-Milford, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
New Haven-Milford, CT E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.24
New Haven-Milford, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.52
New Haven-Milford, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.85
New Haven-Milford, CT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.89
New Haven-Milford, CT E0156 SEAT ATTACHMENT, WALKER NU $14.75
New Haven-Milford, CT E0156 SEAT ATTACHMENT, WALKER RR $1.48
New Haven-Milford, CT E0156 SEAT ATTACHMENT, WALKER UE $11.06
New Haven-Milford, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $60.00
New Haven-Milford, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $6.00
New Haven-Milford, CT E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $45.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 141 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
New Haven-Milford, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.36
New Haven-Milford, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.04
New Haven-Milford, CT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.27
New Haven-Milford, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.85
New Haven-Milford, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.29
New Haven-Milford, CT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.64
New Orleans-Metairie-Kenner, LA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.95
New Orleans-Metairie-Kenner, LA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.80
New Orleans-Metairie-Kenner, LA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.96
New Orleans-Metairie-Kenner, LA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.10
New Orleans-Metairie-Kenner, LA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.71
New Orleans-Metairie-Kenner, LA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.33
New Orleans-Metairie-Kenner, LA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $263.90
New Orleans-Metairie-Kenner, LA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.39
New Orleans-Metairie-Kenner, LA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.93
New Orleans-Metairie-Kenner, LA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $72.72
New Orleans-Metairie-Kenner, LA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.27
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
New Orleans-Metairie-Kenner, LA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $54.54
New Orleans-Metairie-Kenner, LA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.50
New Orleans-Metairie-Kenner, LA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.25
New Orleans-Metairie-Kenner, LA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.38
New Orleans-Metairie-Kenner, LA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $384.24
New Orleans-Metairie-Kenner, LA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.42
New Orleans-Metairie-Kenner, LA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $288.18
New Orleans-Metairie-Kenner, LA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.53
New Orleans-Metairie-Kenner, LA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.35
New Orleans-Metairie-Kenner, LA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.65
New Orleans-Metairie-Kenner, LA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $133.62
New Orleans-Metairie-Kenner, LA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.36
New Orleans-Metairie-Kenner, LA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $100.22
New Orleans-Metairie-Kenner, LA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $46.33
New Orleans-Metairie-Kenner, LA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.63
New Orleans-Metairie-Kenner, LA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $34.75
New Orleans-Metairie-Kenner, LA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.80
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
New Orleans-Metairie-Kenner, LA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.88
New Orleans-Metairie-Kenner, LA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.10
New Orleans-Metairie-Kenner, LA E0156 SEAT ATTACHMENT, WALKER NU $15.20
New Orleans-Metairie-Kenner, LA E0156 SEAT ATTACHMENT, WALKER RR $1.52
New Orleans-Metairie-Kenner, LA E0156 SEAT ATTACHMENT, WALKER UE $11.40
New Orleans-Metairie-Kenner, LA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $57.27
New Orleans-Metairie-Kenner, LA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.73
New Orleans-Metairie-Kenner, LA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $42.95
New Orleans-Metairie-Kenner, LA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.02
New Orleans-Metairie-Kenner, LA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.00
New Orleans-Metairie-Kenner, LA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.02
New Orleans-Metairie-Kenner, LA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.84
New Orleans-Metairie-Kenner, LA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
New Orleans-Metairie-Kenner, LA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.63
North East NY CBA Metro E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
North East NY CBA Metro E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
North East NY CBA Metro E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 144 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
North East NY CBA Metro E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.98
North East NY CBA Metro E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.00
North East NY CBA Metro E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.99
North East NY CBA Metro E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $233.76
North East NY CBA Metro E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.38
North East NY CBA Metro E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $175.32
North East NY CBA Metro E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $63.51
North East NY CBA Metro E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.35
North East NY CBA Metro E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.63
North East NY CBA Metro E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.49
North East NY CBA Metro E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.05
North East NY CBA Metro E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.87
North East NY CBA Metro E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $345.81
North East NY CBA Metro E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $34.58
North East NY CBA Metro E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $259.36
North East NY CBA Metro E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $70.00
North East NY CBA Metro E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 145 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
North East NY CBA Metro E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $52.50
North East NY CBA Metro E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $99.92
North East NY CBA Metro E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.99
North East NY CBA Metro E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $74.94
North East NY CBA Metro E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
North East NY CBA Metro E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
North East NY CBA Metro E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
North East NY CBA Metro E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $16.67
North East NY CBA Metro E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.67
North East NY CBA Metro E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.50
North East NY CBA Metro E0156 SEAT ATTACHMENT, WALKER NU $14.00
North East NY CBA Metro E0156 SEAT ATTACHMENT, WALKER RR $1.40
North East NY CBA Metro E0156 SEAT ATTACHMENT, WALKER UE $10.50
North East NY CBA Metro E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.42
North East NY CBA Metro E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.64
North East NY CBA Metro E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.82
North East NY CBA Metro E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 146 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
North East NY CBA Metro E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.70
North East NY CBA Metro E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.75
North East NY CBA Metro E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.00
North East NY CBA Metro E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.20
North East NY CBA Metro E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.00
North Port-Bradenton-Sarasota, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.38
North Port-Bradenton-Sarasota, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.24
North Port-Bradenton-Sarasota, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.79
North Port-Bradenton-Sarasota, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.62
North Port-Bradenton-Sarasota, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.46
North Port-Bradenton-Sarasota, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.47
North Port-Bradenton-Sarasota, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $229.94
North Port-Bradenton-Sarasota, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $22.99
North Port-Bradenton-Sarasota, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $172.46
North Port-Bradenton-Sarasota, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $62.86
North Port-Bradenton-Sarasota, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.29
North Port-Bradenton-Sarasota, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.15
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 147 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
North Port-Bradenton-Sarasota, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.80
North Port-Bradenton-Sarasota, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.18
North Port-Bradenton-Sarasota, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.85
North Port-Bradenton-Sarasota, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $332.50
North Port-Bradenton-Sarasota, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $33.25
North Port-Bradenton-Sarasota, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $249.38
North Port-Bradenton-Sarasota, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $75.50
North Port-Bradenton-Sarasota, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.55
North Port-Bradenton-Sarasota, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.63
North Port-Bradenton-Sarasota, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.32
North Port-Bradenton-Sarasota, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.53
North Port-Bradenton-Sarasota, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.99
North Port-Bradenton-Sarasota, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.50
North Port-Bradenton-Sarasota, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.55
North Port-Bradenton-Sarasota, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.63
North Port-Bradenton-Sarasota, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $16.50
North Port-Bradenton-Sarasota, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.65
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 148 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
North Port-Bradenton-Sarasota, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.38
North Port-Bradenton-Sarasota, FL E0156 SEAT ATTACHMENT, WALKER NU $12.82
North Port-Bradenton-Sarasota, FL E0156 SEAT ATTACHMENT, WALKER RR $1.28
North Port-Bradenton-Sarasota, FL E0156 SEAT ATTACHMENT, WALKER UE $9.62
North Port-Bradenton-Sarasota, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $44.15
North Port-Bradenton-Sarasota, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.42
North Port-Bradenton-Sarasota, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $33.11
North Port-Bradenton-Sarasota, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.00
North Port-Bradenton-Sarasota, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.70
North Port-Bradenton-Sarasota, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.75
North Port-Bradenton-Sarasota, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.94
North Port-Bradenton-Sarasota, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.19
North Port-Bradenton-Sarasota, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.96
Northern NJ Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.64
Northern NJ Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.16
Northern NJ Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.23
Northern NJ Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.19
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Northern NJ Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.02
Northern NJ Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.14
Northern NJ Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $240.58
Northern NJ Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.06
Northern NJ Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $180.44
Northern NJ Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $63.42
Northern NJ Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.34
Northern NJ Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $47.57
Northern NJ Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.28
Northern NJ Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.53
Northern NJ Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.46
Northern NJ Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $364.50
Northern NJ Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.45
Northern NJ Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $273.38
Northern NJ Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $75.44
Northern NJ Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.54
Northern NJ Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.58
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Northern NJ Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $123.04
Northern NJ Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.30
Northern NJ Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $92.28
Northern NJ Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.33
Northern NJ Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.03
Northern NJ Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.25
Northern NJ Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.32
Northern NJ Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
Northern NJ Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.99
Northern NJ Metro CBA E0156 SEAT ATTACHMENT, WALKER NU $14.64
Northern NJ Metro CBA E0156 SEAT ATTACHMENT, WALKER RR $1.46
Northern NJ Metro CBA E0156 SEAT ATTACHMENT, WALKER UE $10.98
Northern NJ Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $47.29
Northern NJ Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.73
Northern NJ Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $35.47
Northern NJ Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.50
Northern NJ Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.75
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Northern NJ Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.13
Northern NJ Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.55
Northern NJ Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.26
Northern NJ Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.41
Northern-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.56
Northern-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.66
Northern-Chicago Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.92
Northern-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.07
Northern-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.51
Northern-Chicago Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.80
Northern-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $261.50
Northern-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.15
Northern-Chicago Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $196.13
Northern-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $68.14
Northern-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.81
Northern-Chicago Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.11
Northern-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.25
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Northern-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.73
Northern-Chicago Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.94
Northern-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Northern-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Northern-Chicago Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Northern-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.50
Northern-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.25
Northern-Chicago Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.88
Northern-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $133.20
Northern-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.32
Northern-Chicago Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $99.90
Northern-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.19
Northern-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.22
Northern-Chicago Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.64
Northern-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.25
Northern-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.83
Northern-Chicago Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.69
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Northern-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER NU $15.14
Northern-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER RR $1.51
Northern-Chicago Metro CBA E0156 SEAT ATTACHMENT, WALKER UE $11.36
Northern-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $51.48
Northern-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.15
Northern-Chicago Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $38.61
Northern-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.18
Northern-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.92
Northern-Chicago Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.39
Northern-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.54
Northern-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.25
Northern-Chicago Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.41
Ocala, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.29
Ocala, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.33
Ocala, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.47
Ocala, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.69
Ocala, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.27
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Ocala, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.02
Ocala, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $239.87
Ocala, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.99
Ocala, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $179.90
Ocala, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $72.74
Ocala, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.27
Ocala, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $54.56
Ocala, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.42
Ocala, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.14
Ocala, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.57
Ocala, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $330.90
Ocala, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $33.09
Ocala, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $248.18
Ocala, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.00
Ocala, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.20
Ocala, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.50
Ocala, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.65
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Ocala, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.57
Ocala, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.24
Ocala, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $38.00
Ocala, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.80
Ocala, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $28.50
Ocala, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.50
Ocala, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.85
Ocala, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.88
Ocala, FL E0156 SEAT ATTACHMENT, WALKER NU $12.36
Ocala, FL E0156 SEAT ATTACHMENT, WALKER RR $1.24
Ocala, FL E0156 SEAT ATTACHMENT, WALKER UE $9.27
Ocala, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.30
Ocala, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.63
Ocala, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.73
Ocala, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.19
Ocala, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.82
Ocala, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.64
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Ocala, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.88
Ocala, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.19
Ocala, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.91
Oklahoma City, OK E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.28
Oklahoma City, OK E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Oklahoma City, OK E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.21
Oklahoma City, OK E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
Oklahoma City, OK E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Oklahoma City, OK E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
Oklahoma City, OK E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $240.00
Oklahoma City, OK E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.00
Oklahoma City, OK E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $180.00
Oklahoma City, OK E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.47
Oklahoma City, OK E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.55
Oklahoma City, OK E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.10
Oklahoma City, OK E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Oklahoma City, OK E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Oklahoma City, OK E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Oklahoma City, OK E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Oklahoma City, OK E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
Oklahoma City, OK E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Oklahoma City, OK E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $74.00
Oklahoma City, OK E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.40
Oklahoma City, OK E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $55.50
Oklahoma City, OK E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $103.32
Oklahoma City, OK E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.33
Oklahoma City, OK E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $77.49
Oklahoma City, OK E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.60
Oklahoma City, OK E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.96
Oklahoma City, OK E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.70
Oklahoma City, OK E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.25
Oklahoma City, OK E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
Oklahoma City, OK E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.94
Oklahoma City, OK E0156 SEAT ATTACHMENT, WALKER NU $14.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Oklahoma City, OK E0156 SEAT ATTACHMENT, WALKER RR $1.40
Oklahoma City, OK E0156 SEAT ATTACHMENT, WALKER UE $10.50
Oklahoma City, OK E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.00
Oklahoma City, OK E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.80
Oklahoma City, OK E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.00
Oklahoma City, OK E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.06
Oklahoma City, OK E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.71
Oklahoma City, OK E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.80
Oklahoma City, OK E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.38
Oklahoma City, OK E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.24
Oklahoma City, OK E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.29
Omaha-Council Bluffs, NE-IA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.13
Omaha-Council Bluffs, NE-IA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.71
Omaha-Council Bluffs, NE-IA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.35
Omaha-Council Bluffs, NE-IA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.00
Omaha-Council Bluffs, NE-IA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
Omaha-Council Bluffs, NE-IA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.50
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Omaha-Council Bluffs, NE-IA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Omaha-Council Bluffs, NE-IA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Omaha-Council Bluffs, NE-IA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Omaha-Council Bluffs, NE-IA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.29
Omaha-Council Bluffs, NE-IA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.73
Omaha-Council Bluffs, NE-IA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.47
Omaha-Council Bluffs, NE-IA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
Omaha-Council Bluffs, NE-IA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
Omaha-Council Bluffs, NE-IA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
Omaha-Council Bluffs, NE-IA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $383.15
Omaha-Council Bluffs, NE-IA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.32
Omaha-Council Bluffs, NE-IA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $287.36
Omaha-Council Bluffs, NE-IA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.60
Omaha-Council Bluffs, NE-IA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.46
Omaha-Council Bluffs, NE-IA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.45
Omaha-Council Bluffs, NE-IA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $117.78
Omaha-Council Bluffs, NE-IA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.78
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Omaha-Council Bluffs, NE-IA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $88.34
Omaha-Council Bluffs, NE-IA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Omaha-Council Bluffs, NE-IA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Omaha-Council Bluffs, NE-IA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Omaha-Council Bluffs, NE-IA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Omaha-Council Bluffs, NE-IA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Omaha-Council Bluffs, NE-IA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Omaha-Council Bluffs, NE-IA E0156 SEAT ATTACHMENT, WALKER NU $14.50
Omaha-Council Bluffs, NE-IA E0156 SEAT ATTACHMENT, WALKER RR $1.45
Omaha-Council Bluffs, NE-IA E0156 SEAT ATTACHMENT, WALKER UE $10.88
Omaha-Council Bluffs, NE-IA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.98
Omaha-Council Bluffs, NE-IA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
Omaha-Council Bluffs, NE-IA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.49
Omaha-Council Bluffs, NE-IA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.23
Omaha-Council Bluffs, NE-IA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.82
Omaha-Council Bluffs, NE-IA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.67
Omaha-Council Bluffs, NE-IA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 161 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Omaha-Council Bluffs, NE-IA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Omaha-Council Bluffs, NE-IA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Orange County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.86
Orange County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Orange County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.65
Orange County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.25
Orange County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Orange County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.19
Orange County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $247.00
Orange County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.70
Orange County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $185.25
Orange County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.97
Orange County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.00
Orange County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.48
Orange County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $48.00
Orange County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.80
Orange County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $36.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 162 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Orange County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $298.91
Orange County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $29.89
Orange County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $224.18
Orange County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $70.00
Orange County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.00
Orange County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $52.50
Orange County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $112.61
Orange County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.26
Orange County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $84.46
Orange County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.70
Orange County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.97
Orange County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.78
Orange County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Orange County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Orange County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Orange County CBA E0156 SEAT ATTACHMENT, WALKER NU $13.70
Orange County CBA E0156 SEAT ATTACHMENT, WALKER RR $1.37
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 163 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Orange County CBA E0156 SEAT ATTACHMENT, WALKER UE $10.28
Orange County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $43.99
Orange County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.40
Orange County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $32.99
Orange County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.86
Orange County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.79
Orange County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.40
Orange County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.35
Orange County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.24
Orange County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.26
Oxnard-Thousand Oaks-Ventura, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.45
Oxnard-Thousand Oaks-Ventura, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.45
Oxnard-Thousand Oaks-Ventura, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.34
Oxnard-Thousand Oaks-Ventura, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.35
Oxnard-Thousand Oaks-Ventura, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.24
Oxnard-Thousand Oaks-Ventura, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.76
Oxnard-Thousand Oaks-Ventura, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $244.58
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Oxnard-Thousand Oaks-Ventura, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.46
Oxnard-Thousand Oaks-Ventura, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $183.44
Oxnard-Thousand Oaks-Ventura, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.84
Oxnard-Thousand Oaks-Ventura, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.98
Oxnard-Thousand Oaks-Ventura, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.38
Oxnard-Thousand Oaks-Ventura, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Oxnard-Thousand Oaks-Ventura, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Oxnard-Thousand Oaks-Ventura, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Oxnard-Thousand Oaks-Ventura, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $326.71
Oxnard-Thousand Oaks-Ventura, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $32.67
Oxnard-Thousand Oaks-Ventura, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $245.03
Oxnard-Thousand Oaks-Ventura, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $75.99
Oxnard-Thousand Oaks-Ventura, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.60
Oxnard-Thousand Oaks-Ventura, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.99
Oxnard-Thousand Oaks-Ventura, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $117.00
Oxnard-Thousand Oaks-Ventura, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.70
Oxnard-Thousand Oaks-Ventura, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $87.75
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 165 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Oxnard-Thousand Oaks-Ventura, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.99
Oxnard-Thousand Oaks-Ventura, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Oxnard-Thousand Oaks-Ventura, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.99
Oxnard-Thousand Oaks-Ventura, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Oxnard-Thousand Oaks-Ventura, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Oxnard-Thousand Oaks-Ventura, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Oxnard-Thousand Oaks-Ventura, CA E0156 SEAT ATTACHMENT, WALKER NU $14.18
Oxnard-Thousand Oaks-Ventura, CA E0156 SEAT ATTACHMENT, WALKER RR $1.42
Oxnard-Thousand Oaks-Ventura, CA E0156 SEAT ATTACHMENT, WALKER UE $10.64
Oxnard-Thousand Oaks-Ventura, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.11
Oxnard-Thousand Oaks-Ventura, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.91
Oxnard-Thousand Oaks-Ventura, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.83
Oxnard-Thousand Oaks-Ventura, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.00
Oxnard-Thousand Oaks-Ventura, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.90
Oxnard-Thousand Oaks-Ventura, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.25
Oxnard-Thousand Oaks-Ventura, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
Oxnard-Thousand Oaks-Ventura, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 166 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Oxnard-Thousand Oaks-Ventura, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Palm Bay-Melbourne-Titusville, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.14
Palm Bay-Melbourne-Titusville, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.01
Palm Bay-Melbourne-Titusville, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.11
Palm Bay-Melbourne-Titusville, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.47
Palm Bay-Melbourne-Titusville, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.35
Palm Bay-Melbourne-Titusville, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.60
Palm Bay-Melbourne-Titusville, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $232.44
Palm Bay-Melbourne-Titusville, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.24
Palm Bay-Melbourne-Titusville, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $174.33
Palm Bay-Melbourne-Titusville, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $60.86
Palm Bay-Melbourne-Titusville, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.09
Palm Bay-Melbourne-Titusville, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $45.65
Palm Bay-Melbourne-Titusville, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.51
Palm Bay-Melbourne-Titusville, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.15
Palm Bay-Melbourne-Titusville, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.63
Palm Bay-Melbourne-Titusville, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $320.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 167 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Palm Bay-Melbourne-Titusville, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $32.00
Palm Bay-Melbourne-Titusville, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $240.00
Palm Bay-Melbourne-Titusville, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $73.60
Palm Bay-Melbourne-Titusville, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.36
Palm Bay-Melbourne-Titusville, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $55.20
Palm Bay-Melbourne-Titusville, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $122.50
Palm Bay-Melbourne-Titusville, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.25
Palm Bay-Melbourne-Titusville, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $91.88
Palm Bay-Melbourne-Titusville, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.25
Palm Bay-Melbourne-Titusville, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.53
Palm Bay-Melbourne-Titusville, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.44
Palm Bay-Melbourne-Titusville, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $15.89
Palm Bay-Melbourne-Titusville, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.59
Palm Bay-Melbourne-Titusville, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $11.92
Palm Bay-Melbourne-Titusville, FL E0156 SEAT ATTACHMENT, WALKER NU $12.82
Palm Bay-Melbourne-Titusville, FL E0156 SEAT ATTACHMENT, WALKER RR $1.28
Palm Bay-Melbourne-Titusville, FL E0156 SEAT ATTACHMENT, WALKER UE $9.62
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 168 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Palm Bay-Melbourne-Titusville, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $43.00
Palm Bay-Melbourne-Titusville, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.30
Palm Bay-Melbourne-Titusville, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $32.25
Palm Bay-Melbourne-Titusville, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $16.16
Palm Bay-Melbourne-Titusville, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.62
Palm Bay-Melbourne-Titusville, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.12
Palm Bay-Melbourne-Titusville, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.88
Palm Bay-Melbourne-Titusville, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.19
Palm Bay-Melbourne-Titusville, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.91
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.00
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.50
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.30
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.03
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.23
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $238.69
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.87
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 169 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $179.02
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $61.91
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.19
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $46.43
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.21
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.62
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.16
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $76.00
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.60
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $57.00
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $123.58
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.36
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $92.69
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 170 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.21
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.72
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.91
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0156 SEAT ATTACHMENT, WALKER NU $15.10
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0156 SEAT ATTACHMENT, WALKER RR $1.51
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0156 SEAT ATTACHMENT, WALKER UE $11.33
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.42
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.64
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.82
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.00
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.80
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.50
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 171 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Phoenix-Mesa-Glendale, AZ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.82
Phoenix-Mesa-Glendale, AZ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.38
Phoenix-Mesa-Glendale, AZ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.87
Phoenix-Mesa-Glendale, AZ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.39
Phoenix-Mesa-Glendale, AZ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.44
Phoenix-Mesa-Glendale, AZ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.29
Phoenix-Mesa-Glendale, AZ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $240.44
Phoenix-Mesa-Glendale, AZ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.04
Phoenix-Mesa-Glendale, AZ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $180.33
Phoenix-Mesa-Glendale, AZ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.47
Phoenix-Mesa-Glendale, AZ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.55
Phoenix-Mesa-Glendale, AZ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.10
Phoenix-Mesa-Glendale, AZ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Phoenix-Mesa-Glendale, AZ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Phoenix-Mesa-Glendale, AZ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Phoenix-Mesa-Glendale, AZ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $330.00
Phoenix-Mesa-Glendale, AZ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $33.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 172 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Phoenix-Mesa-Glendale, AZ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $247.50
Phoenix-Mesa-Glendale, AZ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.62
Phoenix-Mesa-Glendale, AZ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.76
Phoenix-Mesa-Glendale, AZ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.22
Phoenix-Mesa-Glendale, AZ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $128.00
Phoenix-Mesa-Glendale, AZ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.80
Phoenix-Mesa-Glendale, AZ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $96.00
Phoenix-Mesa-Glendale, AZ E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Phoenix-Mesa-Glendale, AZ E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Phoenix-Mesa-Glendale, AZ E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
Phoenix-Mesa-Glendale, AZ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.88
Phoenix-Mesa-Glendale, AZ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.79
Phoenix-Mesa-Glendale, AZ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.41
Phoenix-Mesa-Glendale, AZ E0156 SEAT ATTACHMENT, WALKER NU $15.08
Phoenix-Mesa-Glendale, AZ E0156 SEAT ATTACHMENT, WALKER RR $1.51
Phoenix-Mesa-Glendale, AZ E0156 SEAT ATTACHMENT, WALKER UE $11.31
Phoenix-Mesa-Glendale, AZ E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.30
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 173 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Phoenix-Mesa-Glendale, AZ E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.93
Phoenix-Mesa-Glendale, AZ E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.98
Phoenix-Mesa-Glendale, AZ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.00
Phoenix-Mesa-Glendale, AZ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.80
Phoenix-Mesa-Glendale, AZ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.50
Phoenix-Mesa-Glendale, AZ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.38
Phoenix-Mesa-Glendale, AZ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.24
Phoenix-Mesa-Glendale, AZ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.29
Portland-Vancouver-Hillsboro, OR-WA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.69
Portland-Vancouver-Hillsboro, OR-WA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.57
Portland-Vancouver-Hillsboro, OR-WA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.27
Portland-Vancouver-Hillsboro, OR-WA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.43
Portland-Vancouver-Hillsboro, OR-WA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.44
Portland-Vancouver-Hillsboro, OR-WA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.32
Portland-Vancouver-Hillsboro, OR-WA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $247.12
Portland-Vancouver-Hillsboro, OR-WA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.71
Portland-Vancouver-Hillsboro, OR-WA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $185.34
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 174 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Portland-Vancouver-Hillsboro, OR-WA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $70.33
Portland-Vancouver-Hillsboro, OR-WA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.03
Portland-Vancouver-Hillsboro, OR-WA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.75
Portland-Vancouver-Hillsboro, OR-WA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $58.22
Portland-Vancouver-Hillsboro, OR-WA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.82
Portland-Vancouver-Hillsboro, OR-WA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $43.67
Portland-Vancouver-Hillsboro, OR-WA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $393.79
Portland-Vancouver-Hillsboro, OR-WA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $39.38
Portland-Vancouver-Hillsboro, OR-WA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $295.34
Portland-Vancouver-Hillsboro, OR-WA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.00
Portland-Vancouver-Hillsboro, OR-WA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.30
Portland-Vancouver-Hillsboro, OR-WA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.25
Portland-Vancouver-Hillsboro, OR-WA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $128.32
Portland-Vancouver-Hillsboro, OR-WA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.83
Portland-Vancouver-Hillsboro, OR-WA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $96.24
Portland-Vancouver-Hillsboro, OR-WA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $44.00
Portland-Vancouver-Hillsboro, OR-WA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.40
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 175 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Portland-Vancouver-Hillsboro, OR-WA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $33.00
Portland-Vancouver-Hillsboro, OR-WA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.37
Portland-Vancouver-Hillsboro, OR-WA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.84
Portland-Vancouver-Hillsboro, OR-WA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.78
Portland-Vancouver-Hillsboro, OR-WA E0156 SEAT ATTACHMENT, WALKER NU $15.50
Portland-Vancouver-Hillsboro, OR-WA E0156 SEAT ATTACHMENT, WALKER RR $1.55
Portland-Vancouver-Hillsboro, OR-WA E0156 SEAT ATTACHMENT, WALKER UE $11.63
Portland-Vancouver-Hillsboro, OR-WA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $60.00
Portland-Vancouver-Hillsboro, OR-WA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $6.00
Portland-Vancouver-Hillsboro, OR-WA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $45.00
Portland-Vancouver-Hillsboro, OR-WA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.25
Portland-Vancouver-Hillsboro, OR-WA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.83
Portland-Vancouver-Hillsboro, OR-WA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.69
Portland-Vancouver-Hillsboro, OR-WA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.75
Portland-Vancouver-Hillsboro, OR-WA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Portland-Vancouver-Hillsboro, OR-WA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.56
Poughkeepsie-Newburgh-Middletown, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.35
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 176 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Poughkeepsie-Newburgh-Middletown, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.14
Poughkeepsie-Newburgh-Middletown, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.01
Poughkeepsie-Newburgh-Middletown, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $39.40
Poughkeepsie-Newburgh-Middletown, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.94
Poughkeepsie-Newburgh-Middletown, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $29.55
Poughkeepsie-Newburgh-Middletown, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $240.98
Poughkeepsie-Newburgh-Middletown, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.10
Poughkeepsie-Newburgh-Middletown, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $180.74
Poughkeepsie-Newburgh-Middletown, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $61.56
Poughkeepsie-Newburgh-Middletown, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.16
Poughkeepsie-Newburgh-Middletown, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $46.17
Poughkeepsie-Newburgh-Middletown, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.24
Poughkeepsie-Newburgh-Middletown, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.02
Poughkeepsie-Newburgh-Middletown, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.68
Poughkeepsie-Newburgh-Middletown, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $347.90
Poughkeepsie-Newburgh-Middletown, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $34.79
Poughkeepsie-Newburgh-Middletown, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $260.93
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 177 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Poughkeepsie-Newburgh-Middletown, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $74.86
Poughkeepsie-Newburgh-Middletown, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.49
Poughkeepsie-Newburgh-Middletown, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.15
Poughkeepsie-Newburgh-Middletown, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $102.26
Poughkeepsie-Newburgh-Middletown, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.23
Poughkeepsie-Newburgh-Middletown, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $76.70
Poughkeepsie-Newburgh-Middletown, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Poughkeepsie-Newburgh-Middletown, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Poughkeepsie-Newburgh-Middletown, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Poughkeepsie-Newburgh-Middletown, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.07
Poughkeepsie-Newburgh-Middletown, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.71
Poughkeepsie-Newburgh-Middletown, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.80
Poughkeepsie-Newburgh-Middletown, NY E0156 SEAT ATTACHMENT, WALKER NU $14.25
Poughkeepsie-Newburgh-Middletown, NY E0156 SEAT ATTACHMENT, WALKER RR $1.43
Poughkeepsie-Newburgh-Middletown, NY E0156 SEAT ATTACHMENT, WALKER UE $10.69
Poughkeepsie-Newburgh-Middletown, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.80
Poughkeepsie-Newburgh-Middletown, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.88
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 178 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Poughkeepsie-Newburgh-Middletown, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.60
Poughkeepsie-Newburgh-Middletown, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.14
Poughkeepsie-Newburgh-Middletown, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.71
Poughkeepsie-Newburgh-Middletown, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.86
Poughkeepsie-Newburgh-Middletown, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.96
Poughkeepsie-Newburgh-Middletown, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Poughkeepsie-Newburgh-Middletown, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.72
Providence-New Bedford-Fall River, RI-MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.00
Providence-New Bedford-Fall River, RI-MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
Providence-New Bedford-Fall River, RI-MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.50
Providence-New Bedford-Fall River, RI-MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.86
Providence-New Bedford-Fall River, RI-MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Providence-New Bedford-Fall River, RI-MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.65
Providence-New Bedford-Fall River, RI-MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Providence-New Bedford-Fall River, RI-MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Providence-New Bedford-Fall River, RI-MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Providence-New Bedford-Fall River, RI-MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $75.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 179 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Providence-New Bedford-Fall River, RI-MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.50
Providence-New Bedford-Fall River, RI-MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $56.25
Providence-New Bedford-Fall River, RI-MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.00
Providence-New Bedford-Fall River, RI-MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.10
Providence-New Bedford-Fall River, RI-MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.25
Providence-New Bedford-Fall River, RI-MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Providence-New Bedford-Fall River, RI-MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
Providence-New Bedford-Fall River, RI-MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Providence-New Bedford-Fall River, RI-MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.00
Providence-New Bedford-Fall River, RI-MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.20
Providence-New Bedford-Fall River, RI-MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.50
Providence-New Bedford-Fall River, RI-MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $126.23
Providence-New Bedford-Fall River, RI-MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.62
Providence-New Bedford-Fall River, RI-MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.67
Providence-New Bedford-Fall River, RI-MA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Providence-New Bedford-Fall River, RI-MA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Providence-New Bedford-Fall River, RI-MA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 180 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Providence-New Bedford-Fall River, RI-MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Providence-New Bedford-Fall River, RI-MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Providence-New Bedford-Fall River, RI-MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Providence-New Bedford-Fall River, RI-MA E0156 SEAT ATTACHMENT, WALKER NU $15.10
Providence-New Bedford-Fall River, RI-MA E0156 SEAT ATTACHMENT, WALKER RR $1.51
Providence-New Bedford-Fall River, RI-MA E0156 SEAT ATTACHMENT, WALKER UE $11.33
Providence-New Bedford-Fall River, RI-MA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $60.00
Providence-New Bedford-Fall River, RI-MA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $6.00
Providence-New Bedford-Fall River, RI-MA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $45.00
Providence-New Bedford-Fall River, RI-MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
Providence-New Bedford-Fall River, RI-MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Providence-New Bedford-Fall River, RI-MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Providence-New Bedford-Fall River, RI-MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Providence-New Bedford-Fall River, RI-MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Providence-New Bedford-Fall River, RI-MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Raleigh-Cary, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.00
Raleigh-Cary, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 181 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Raleigh-Cary, NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.50
Raleigh-Cary, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.00
Raleigh-Cary, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.80
Raleigh-Cary, NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.00
Raleigh-Cary, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Raleigh-Cary, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Raleigh-Cary, NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Raleigh-Cary, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $75.00
Raleigh-Cary, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.50
Raleigh-Cary, NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $56.25
Raleigh-Cary, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.49
Raleigh-Cary, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.55
Raleigh-Cary, NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.62
Raleigh-Cary, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Raleigh-Cary, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
Raleigh-Cary, NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Raleigh-Cary, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.34
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Raleigh-Cary, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.23
Raleigh-Cary, NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.76
Raleigh-Cary, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $132.61
Raleigh-Cary, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.26
Raleigh-Cary, NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $99.46
Raleigh-Cary, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.12
Raleigh-Cary, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.11
Raleigh-Cary, NC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.84
Raleigh-Cary, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.55
Raleigh-Cary, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Raleigh-Cary, NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.91
Raleigh-Cary, NC E0156 SEAT ATTACHMENT, WALKER NU $15.32
Raleigh-Cary, NC E0156 SEAT ATTACHMENT, WALKER RR $1.53
Raleigh-Cary, NC E0156 SEAT ATTACHMENT, WALKER UE $11.49
Raleigh-Cary, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $56.13
Raleigh-Cary, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.61
Raleigh-Cary, NC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $42.10
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Raleigh-Cary, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.75
Raleigh-Cary, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.08
Raleigh-Cary, NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.56
Raleigh-Cary, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $14.00
Raleigh-Cary, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.40
Raleigh-Cary, NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.50
Richmond, VA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.04
Richmond, VA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.80
Richmond, VA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.03
Richmond, VA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.39
Richmond, VA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.44
Richmond, VA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.29
Richmond, VA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $290.00
Richmond, VA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.00
Richmond, VA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $217.50
Richmond, VA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $73.98
Richmond, VA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.40
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Richmond, VA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $55.49
Richmond, VA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $52.04
Richmond, VA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.20
Richmond, VA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.03
Richmond, VA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $404.43
Richmond, VA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $40.44
Richmond, VA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $303.32
Richmond, VA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.60
Richmond, VA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.46
Richmond, VA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.45
Richmond, VA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.10
Richmond, VA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.51
Richmond, VA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.83
Richmond, VA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.54
Richmond, VA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Richmond, VA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.66
Richmond, VA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Richmond, VA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Richmond, VA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Richmond, VA E0156 SEAT ATTACHMENT, WALKER NU $17.17
Richmond, VA E0156 SEAT ATTACHMENT, WALKER RR $1.72
Richmond, VA E0156 SEAT ATTACHMENT, WALKER UE $12.88
Richmond, VA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $52.00
Richmond, VA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.20
Richmond, VA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.00
Richmond, VA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.24
Richmond, VA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.92
Richmond, VA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.43
Richmond, VA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
Richmond, VA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
Richmond, VA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Rochester, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.13
Rochester, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.71
Rochester, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.35
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Rochester, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.00
Rochester, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.50
Rochester, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.75
Rochester, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $295.00
Rochester, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $29.50
Rochester, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $221.25
Rochester, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.29
Rochester, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.73
Rochester, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.47
Rochester, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Rochester, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Rochester, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Rochester, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $380.00
Rochester, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.00
Rochester, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $285.00
Rochester, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.00
Rochester, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.20
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Rochester, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.50
Rochester, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $121.92
Rochester, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.19
Rochester, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $91.44
Rochester, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.66
Rochester, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.07
Rochester, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.50
Rochester, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.36
Rochester, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.74
Rochester, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.02
Rochester, NY E0156 SEAT ATTACHMENT, WALKER NU $14.79
Rochester, NY E0156 SEAT ATTACHMENT, WALKER RR $1.48
Rochester, NY E0156 SEAT ATTACHMENT, WALKER UE $11.09
Rochester, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.00
Rochester, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
Rochester, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.50
Rochester, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Rochester, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
Rochester, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Rochester, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.00
Rochester, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.30
Rochester, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.75
Sacramento--Arden-Arcade--Roseville, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.76
Sacramento--Arden-Arcade--Roseville, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.58
Sacramento--Arden-Arcade--Roseville, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.32
Sacramento--Arden-Arcade--Roseville, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.08
Sacramento--Arden-Arcade--Roseville, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.31
Sacramento--Arden-Arcade--Roseville, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.31
Sacramento--Arden-Arcade--Roseville, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $244.58
Sacramento--Arden-Arcade--Roseville, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.46
Sacramento--Arden-Arcade--Roseville, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $183.44
Sacramento--Arden-Arcade--Roseville, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.84
Sacramento--Arden-Arcade--Roseville, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.98
Sacramento--Arden-Arcade--Roseville, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.38
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Sacramento--Arden-Arcade--Roseville, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.96
Sacramento--Arden-Arcade--Roseville, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.70
Sacramento--Arden-Arcade--Roseville, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.72
Sacramento--Arden-Arcade--Roseville, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $369.75
Sacramento--Arden-Arcade--Roseville, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.98
Sacramento--Arden-Arcade--Roseville, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $277.31
Sacramento--Arden-Arcade--Roseville, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.50
Sacramento--Arden-Arcade--Roseville, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.85
Sacramento--Arden-Arcade--Roseville, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.88
Sacramento--Arden-Arcade--Roseville, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $118.13
Sacramento--Arden-Arcade--Roseville, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.81
Sacramento--Arden-Arcade--Roseville, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $88.60
Sacramento--Arden-Arcade--Roseville, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.74
Sacramento--Arden-Arcade--Roseville, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.27
Sacramento--Arden-Arcade--Roseville, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.06
Sacramento--Arden-Arcade--Roseville, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.08
Sacramento--Arden-Arcade--Roseville, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.81
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 190 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Sacramento--Arden-Arcade--Roseville, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.56
Sacramento--Arden-Arcade--Roseville, CA E0156 SEAT ATTACHMENT, WALKER NU $14.68
Sacramento--Arden-Arcade--Roseville, CA E0156 SEAT ATTACHMENT, WALKER RR $1.47
Sacramento--Arden-Arcade--Roseville, CA E0156 SEAT ATTACHMENT, WALKER UE $11.01
Sacramento--Arden-Arcade--Roseville, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.56
Sacramento--Arden-Arcade--Roseville, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.86
Sacramento--Arden-Arcade--Roseville, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.42
Sacramento--Arden-Arcade--Roseville, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.78
Sacramento--Arden-Arcade--Roseville, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.88
Sacramento--Arden-Arcade--Roseville, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.09
Sacramento--Arden-Arcade--Roseville, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.00
Sacramento--Arden-Arcade--Roseville, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.20
Sacramento--Arden-Arcade--Roseville, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.00
Salt Lake City, UT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.59
Salt Lake City, UT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.86
Salt Lake City, UT E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.44
Salt Lake City, UT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.22
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Salt Lake City, UT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.02
Salt Lake City, UT E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.17
Salt Lake City, UT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $251.93
Salt Lake City, UT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.19
Salt Lake City, UT E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $188.95
Salt Lake City, UT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $71.14
Salt Lake City, UT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.11
Salt Lake City, UT E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $53.36
Salt Lake City, UT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.14
Salt Lake City, UT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.71
Salt Lake City, UT E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.86
Salt Lake City, UT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $381.58
Salt Lake City, UT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $38.16
Salt Lake City, UT E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $286.19
Salt Lake City, UT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $79.80
Salt Lake City, UT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.98
Salt Lake City, UT E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.85
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Salt Lake City, UT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $118.89
Salt Lake City, UT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.89
Salt Lake City, UT E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $89.17
Salt Lake City, UT E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.04
Salt Lake City, UT E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.10
Salt Lake City, UT E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.78
Salt Lake City, UT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $20.50
Salt Lake City, UT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $2.05
Salt Lake City, UT E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $15.38
Salt Lake City, UT E0156 SEAT ATTACHMENT, WALKER NU $14.75
Salt Lake City, UT E0156 SEAT ATTACHMENT, WALKER RR $1.48
Salt Lake City, UT E0156 SEAT ATTACHMENT, WALKER UE $11.06
Salt Lake City, UT E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $52.30
Salt Lake City, UT E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.23
Salt Lake City, UT E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $39.23
Salt Lake City, UT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.58
Salt Lake City, UT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.06
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Salt Lake City, UT E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.44
Salt Lake City, UT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.34
Salt Lake City, UT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.33
Salt Lake City, UT E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.01
San Antonio-New Braunfels, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.82
San Antonio-New Braunfels, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.18
San Antonio-New Braunfels, TX E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.37
San Antonio-New Braunfels, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.01
San Antonio-New Braunfels, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
San Antonio-New Braunfels, TX E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.51
San Antonio-New Braunfels, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
San Antonio-New Braunfels, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
San Antonio-New Braunfels, TX E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
San Antonio-New Braunfels, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.35
San Antonio-New Braunfels, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.54
San Antonio-New Braunfels, TX E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $49.01
San Antonio-New Braunfels, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 194 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Antonio-New Braunfels, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
San Antonio-New Braunfels, TX E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
San Antonio-New Braunfels, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
San Antonio-New Braunfels, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
San Antonio-New Braunfels, TX E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
San Antonio-New Braunfels, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $74.05
San Antonio-New Braunfels, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.41
San Antonio-New Braunfels, TX E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $55.54
San Antonio-New Braunfels, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $119.70
San Antonio-New Braunfels, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.97
San Antonio-New Braunfels, TX E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $89.78
San Antonio-New Braunfels, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.22
San Antonio-New Braunfels, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.12
San Antonio-New Braunfels, TX E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.92
San Antonio-New Braunfels, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.45
San Antonio-New Braunfels, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.75
San Antonio-New Braunfels, TX E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.09
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 195 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Antonio-New Braunfels, TX E0156 SEAT ATTACHMENT, WALKER NU $13.36
San Antonio-New Braunfels, TX E0156 SEAT ATTACHMENT, WALKER RR $1.34
San Antonio-New Braunfels, TX E0156 SEAT ATTACHMENT, WALKER UE $10.02
San Antonio-New Braunfels, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.47
San Antonio-New Braunfels, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.65
San Antonio-New Braunfels, TX E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.85
San Antonio-New Braunfels, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.00
San Antonio-New Braunfels, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.80
San Antonio-New Braunfels, TX E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.50
San Antonio-New Braunfels, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
San Antonio-New Braunfels, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
San Antonio-New Braunfels, TX E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
San Diego-Carlsbad-San Marcos, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.45
San Diego-Carlsbad-San Marcos, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.45
San Diego-Carlsbad-San Marcos, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.34
San Diego-Carlsbad-San Marcos, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.69
San Diego-Carlsbad-San Marcos, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.27
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Diego-Carlsbad-San Marcos, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.02
San Diego-Carlsbad-San Marcos, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $244.58
San Diego-Carlsbad-San Marcos, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.46
San Diego-Carlsbad-San Marcos, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $183.44
San Diego-Carlsbad-San Marcos, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.84
San Diego-Carlsbad-San Marcos, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.98
San Diego-Carlsbad-San Marcos, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.38
San Diego-Carlsbad-San Marcos, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $50.00
San Diego-Carlsbad-San Marcos, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.00
San Diego-Carlsbad-San Marcos, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $37.50
San Diego-Carlsbad-San Marcos, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $326.71
San Diego-Carlsbad-San Marcos, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $32.67
San Diego-Carlsbad-San Marcos, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $245.03
San Diego-Carlsbad-San Marcos, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.96
San Diego-Carlsbad-San Marcos, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.90
San Diego-Carlsbad-San Marcos, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $59.22
San Diego-Carlsbad-San Marcos, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $117.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Diego-Carlsbad-San Marcos, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.70
San Diego-Carlsbad-San Marcos, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $87.75
San Diego-Carlsbad-San Marcos, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.65
San Diego-Carlsbad-San Marcos, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.17
San Diego-Carlsbad-San Marcos, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.24
San Diego-Carlsbad-San Marcos, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.95
San Diego-Carlsbad-San Marcos, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.90
San Diego-Carlsbad-San Marcos, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.21
San Diego-Carlsbad-San Marcos, CA E0156 SEAT ATTACHMENT, WALKER NU $14.50
San Diego-Carlsbad-San Marcos, CA E0156 SEAT ATTACHMENT, WALKER RR $1.45
San Diego-Carlsbad-San Marcos, CA E0156 SEAT ATTACHMENT, WALKER UE $10.88
San Diego-Carlsbad-San Marcos, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.11
San Diego-Carlsbad-San Marcos, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.91
San Diego-Carlsbad-San Marcos, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.83
San Diego-Carlsbad-San Marcos, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.95
San Diego-Carlsbad-San Marcos, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.90
San Diego-Carlsbad-San Marcos, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.21
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Diego-Carlsbad-San Marcos, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
San Diego-Carlsbad-San Marcos, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
San Diego-Carlsbad-San Marcos, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
San Francisco-Oakland-Fremont, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.25
San Francisco-Oakland-Fremont, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.63
San Francisco-Oakland-Fremont, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.69
San Francisco-Oakland-Fremont, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.82
San Francisco-Oakland-Fremont, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.58
San Francisco-Oakland-Fremont, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.37
San Francisco-Oakland-Fremont, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $262.86
San Francisco-Oakland-Fremont, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.29
San Francisco-Oakland-Fremont, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.15
San Francisco-Oakland-Fremont, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.92
San Francisco-Oakland-Fremont, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.99
San Francisco-Oakland-Fremont, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.44
San Francisco-Oakland-Fremont, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $58.04
San Francisco-Oakland-Fremont, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.80
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 199 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Francisco-Oakland-Fremont, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $43.53
San Francisco-Oakland-Fremont, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $369.75
San Francisco-Oakland-Fremont, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.98
San Francisco-Oakland-Fremont, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $277.31
San Francisco-Oakland-Fremont, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.12
San Francisco-Oakland-Fremont, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.21
San Francisco-Oakland-Fremont, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.59
San Francisco-Oakland-Fremont, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.20
San Francisco-Oakland-Fremont, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.52
San Francisco-Oakland-Fremont, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.90
San Francisco-Oakland-Fremont, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $44.27
San Francisco-Oakland-Fremont, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.43
San Francisco-Oakland-Fremont, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $33.20
San Francisco-Oakland-Fremont, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $19.50
San Francisco-Oakland-Fremont, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.95
San Francisco-Oakland-Fremont, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.63
San Francisco-Oakland-Fremont, CA E0156 SEAT ATTACHMENT, WALKER NU $14.98
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Francisco-Oakland-Fremont, CA E0156 SEAT ATTACHMENT, WALKER RR $1.50
San Francisco-Oakland-Fremont, CA E0156 SEAT ATTACHMENT, WALKER UE $11.24
San Francisco-Oakland-Fremont, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.11
San Francisco-Oakland-Fremont, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.91
San Francisco-Oakland-Fremont, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.83
San Francisco-Oakland-Fremont, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.40
San Francisco-Oakland-Fremont, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.94
San Francisco-Oakland-Fremont, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.55
San Francisco-Oakland-Fremont, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.92
San Francisco-Oakland-Fremont, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.29
San Francisco-Oakland-Fremont, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.69
San Jose-Sunnyvale-Santa Clara, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.32
San Jose-Sunnyvale-Santa Clara, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.63
San Jose-Sunnyvale-Santa Clara, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.74
San Jose-Sunnyvale-Santa Clara, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.04
San Jose-Sunnyvale-Santa Clara, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.50
San Jose-Sunnyvale-Santa Clara, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.78
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Jose-Sunnyvale-Santa Clara, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $251.65
San Jose-Sunnyvale-Santa Clara, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.17
San Jose-Sunnyvale-Santa Clara, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $188.74
San Jose-Sunnyvale-Santa Clara, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $68.56
San Jose-Sunnyvale-Santa Clara, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.86
San Jose-Sunnyvale-Santa Clara, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $51.42
San Jose-Sunnyvale-Santa Clara, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.96
San Jose-Sunnyvale-Santa Clara, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.80
San Jose-Sunnyvale-Santa Clara, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $43.47
San Jose-Sunnyvale-Santa Clara, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $363.78
San Jose-Sunnyvale-Santa Clara, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.38
San Jose-Sunnyvale-Santa Clara, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $272.84
San Jose-Sunnyvale-Santa Clara, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.36
San Jose-Sunnyvale-Santa Clara, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.24
San Jose-Sunnyvale-Santa Clara, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.77
San Jose-Sunnyvale-Santa Clara, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $121.50
San Jose-Sunnyvale-Santa Clara, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.15
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 202 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Jose-Sunnyvale-Santa Clara, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $91.13
San Jose-Sunnyvale-Santa Clara, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.04
San Jose-Sunnyvale-Santa Clara, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
San Jose-Sunnyvale-Santa Clara, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.28
San Jose-Sunnyvale-Santa Clara, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.96
San Jose-Sunnyvale-Santa Clara, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.90
San Jose-Sunnyvale-Santa Clara, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.22
San Jose-Sunnyvale-Santa Clara, CA E0156 SEAT ATTACHMENT, WALKER NU $14.68
San Jose-Sunnyvale-Santa Clara, CA E0156 SEAT ATTACHMENT, WALKER RR $1.47
San Jose-Sunnyvale-Santa Clara, CA E0156 SEAT ATTACHMENT, WALKER UE $11.01
San Jose-Sunnyvale-Santa Clara, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.54
San Jose-Sunnyvale-Santa Clara, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.95
San Jose-Sunnyvale-Santa Clara, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.16
San Jose-Sunnyvale-Santa Clara, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.36
San Jose-Sunnyvale-Santa Clara, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.94
San Jose-Sunnyvale-Santa Clara, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.52
San Jose-Sunnyvale-Santa Clara, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.80
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 203 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
San Jose-Sunnyvale-Santa Clara, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
San Jose-Sunnyvale-Santa Clara, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.60
Scranton--Wilkes-Barre, PA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.29
Scranton--Wilkes-Barre, PA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.13
Scranton--Wilkes-Barre, PA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.97
Scranton--Wilkes-Barre, PA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.82
Scranton--Wilkes-Barre, PA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.28
Scranton--Wilkes-Barre, PA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.12
Scranton--Wilkes-Barre, PA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Scranton--Wilkes-Barre, PA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Scranton--Wilkes-Barre, PA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Scranton--Wilkes-Barre, PA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $65.07
Scranton--Wilkes-Barre, PA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.51
Scranton--Wilkes-Barre, PA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.80
Scranton--Wilkes-Barre, PA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.33
Scranton--Wilkes-Barre, PA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.73
Scranton--Wilkes-Barre, PA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $43.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 204 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Scranton--Wilkes-Barre, PA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $345.79
Scranton--Wilkes-Barre, PA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $34.58
Scranton--Wilkes-Barre, PA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $259.34
Scranton--Wilkes-Barre, PA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.05
Scranton--Wilkes-Barre, PA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.81
Scranton--Wilkes-Barre, PA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.54
Scranton--Wilkes-Barre, PA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $125.10
Scranton--Wilkes-Barre, PA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.51
Scranton--Wilkes-Barre, PA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $93.83
Scranton--Wilkes-Barre, PA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Scranton--Wilkes-Barre, PA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Scranton--Wilkes-Barre, PA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Scranton--Wilkes-Barre, PA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.94
Scranton--Wilkes-Barre, PA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.79
Scranton--Wilkes-Barre, PA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.46
Scranton--Wilkes-Barre, PA E0156 SEAT ATTACHMENT, WALKER NU $14.50
Scranton--Wilkes-Barre, PA E0156 SEAT ATTACHMENT, WALKER RR $1.45
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 205 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Scranton--Wilkes-Barre, PA E0156 SEAT ATTACHMENT, WALKER UE $10.88
Scranton--Wilkes-Barre, PA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $46.88
Scranton--Wilkes-Barre, PA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.69
Scranton--Wilkes-Barre, PA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $35.16
Scranton--Wilkes-Barre, PA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.98
Scranton--Wilkes-Barre, PA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.80
Scranton--Wilkes-Barre, PA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.49
Scranton--Wilkes-Barre, PA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
Scranton--Wilkes-Barre, PA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
Scranton--Wilkes-Barre, PA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Seattle-Tacoma-Bellevue, WA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.76
Seattle-Tacoma-Bellevue, WA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.88
Seattle-Tacoma-Bellevue, WA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.57
Seattle-Tacoma-Bellevue, WA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.44
Seattle-Tacoma-Bellevue, WA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.84
Seattle-Tacoma-Bellevue, WA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.33
Seattle-Tacoma-Bellevue, WA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $263.74
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 206 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Seattle-Tacoma-Bellevue, WA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.37
Seattle-Tacoma-Bellevue, WA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.81
Seattle-Tacoma-Bellevue, WA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $75.92
Seattle-Tacoma-Bellevue, WA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.59
Seattle-Tacoma-Bellevue, WA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $56.94
Seattle-Tacoma-Bellevue, WA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $59.98
Seattle-Tacoma-Bellevue, WA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.00
Seattle-Tacoma-Bellevue, WA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $44.99
Seattle-Tacoma-Bellevue, WA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $407.04
Seattle-Tacoma-Bellevue, WA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $40.70
Seattle-Tacoma-Bellevue, WA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $305.28
Seattle-Tacoma-Bellevue, WA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.84
Seattle-Tacoma-Bellevue, WA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.38
Seattle-Tacoma-Bellevue, WA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.88
Seattle-Tacoma-Bellevue, WA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $138.00
Seattle-Tacoma-Bellevue, WA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.80
Seattle-Tacoma-Bellevue, WA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $103.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 207 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Seattle-Tacoma-Bellevue, WA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $48.00
Seattle-Tacoma-Bellevue, WA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.80
Seattle-Tacoma-Bellevue, WA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $36.00
Seattle-Tacoma-Bellevue, WA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $20.08
Seattle-Tacoma-Bellevue, WA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $2.01
Seattle-Tacoma-Bellevue, WA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $15.06
Seattle-Tacoma-Bellevue, WA E0156 SEAT ATTACHMENT, WALKER NU $17.08
Seattle-Tacoma-Bellevue, WA E0156 SEAT ATTACHMENT, WALKER RR $1.71
Seattle-Tacoma-Bellevue, WA E0156 SEAT ATTACHMENT, WALKER UE $12.81
Seattle-Tacoma-Bellevue, WA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $53.66
Seattle-Tacoma-Bellevue, WA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.37
Seattle-Tacoma-Bellevue, WA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $40.25
Seattle-Tacoma-Bellevue, WA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $21.72
Seattle-Tacoma-Bellevue, WA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.17
Seattle-Tacoma-Bellevue, WA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $16.29
Seattle-Tacoma-Bellevue, WA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.82
Seattle-Tacoma-Bellevue, WA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 208 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Seattle-Tacoma-Bellevue, WA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.62
South-West-Chicago-Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.00
South-West-Chicago-Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
South-West-Chicago-Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.50
South-West-Chicago-Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.00
South-West-Chicago-Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.70
South-West-Chicago-Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.25
South-West-Chicago-Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
South-West-Chicago-Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
South-West-Chicago-Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
South-West-Chicago-Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $73.84
South-West-Chicago-Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.38
South-West-Chicago-Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $55.38
South-West-Chicago-Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.22
South-West-Chicago-Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.62
South-West-Chicago-Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.17
South-West-Chicago-Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $372.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 209 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
South-West-Chicago-Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.25
South-West-Chicago-Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $279.38
South-West-Chicago-Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.00
South-West-Chicago-Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.30
South-West-Chicago-Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.25
South-West-Chicago-Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $135.00
South-West-Chicago-Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.50
South-West-Chicago-Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $101.25
South-West-Chicago-Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.00
South-West-Chicago-Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
South-West-Chicago-Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.25
South-West-Chicago-Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
South-West-Chicago-Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
South-West-Chicago-Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
South-West-Chicago-Metro CBA E0156 SEAT ATTACHMENT, WALKER NU $14.14
South-West-Chicago-Metro CBA E0156 SEAT ATTACHMENT, WALKER RR $1.41
South-West-Chicago-Metro CBA E0156 SEAT ATTACHMENT, WALKER UE $10.61
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 210 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
South-West-Chicago-Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $51.47
South-West-Chicago-Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.15
South-West-Chicago-Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $38.60
South-West-Chicago-Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
South-West-Chicago-Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
South-West-Chicago-Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
South-West-Chicago-Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
South-West-Chicago-Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
South-West-Chicago-Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Southern NY Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.64
Southern NY Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.46
Southern NY Metro CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.48
Southern NY Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.73
Southern NY Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.27
Southern NY Metro CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.05
Southern NY Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $234.24
Southern NY Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.42
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 211 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Southern NY Metro CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $175.68
Southern NY Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $64.50
Southern NY Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.45
Southern NY Metro CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $48.38
Southern NY Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $58.94
Southern NY Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.89
Southern NY Metro CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $44.21
Southern NY Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.36
Southern NY Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.54
Southern NY Metro CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.52
Southern NY Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.34
Southern NY Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.23
Southern NY Metro CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $61.76
Southern NY Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $127.80
Southern NY Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.78
Southern NY Metro CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $95.85
Southern NY Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 212 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Southern NY Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
Southern NY Metro CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.25
Southern NY Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.76
Southern NY Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.78
Southern NY Metro CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.32
Southern NY Metro CBA E0156 SEAT ATTACHMENT, WALKER NU $14.92
Southern NY Metro CBA E0156 SEAT ATTACHMENT, WALKER RR $1.49
Southern NY Metro CBA E0156 SEAT ATTACHMENT, WALKER UE $11.19
Southern NY Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $48.50
Southern NY Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.85
Southern NY Metro CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $36.38
Southern NY Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.62
Southern NY Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.86
Southern NY Metro CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.97
Southern NY Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.61
Southern NY Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.26
Southern NY Metro CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.46
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 213 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Springfield, MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.52
Springfield, MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.55
Springfield, MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.14
Springfield, MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.00
Springfield, MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.60
Springfield, MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.50
Springfield, MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $253.79
Springfield, MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.38
Springfield, MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $190.34
Springfield, MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $70.00
Springfield, MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.00
Springfield, MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.50
Springfield, MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $59.52
Springfield, MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.95
Springfield, MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $44.64
Springfield, MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Springfield, MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 214 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Springfield, MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Springfield, MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.60
Springfield, MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.46
Springfield, MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.45
Springfield, MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $126.23
Springfield, MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.62
Springfield, MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.67
Springfield, MA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.00
Springfield, MA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.30
Springfield, MA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.25
Springfield, MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $19.00
Springfield, MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.90
Springfield, MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.25
Springfield, MA E0156 SEAT ATTACHMENT, WALKER NU $15.00
Springfield, MA E0156 SEAT ATTACHMENT, WALKER RR $1.50
Springfield, MA E0156 SEAT ATTACHMENT, WALKER UE $11.25
Springfield, MA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $57.65
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 215 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Springfield, MA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.77
Springfield, MA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $43.24
Springfield, MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $21.00
Springfield, MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.10
Springfield, MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.75
Springfield, MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.53
Springfield, MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.25
Springfield, MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.40
St. Louis, MO-IL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.16
St. Louis, MO-IL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.52
St. Louis, MO-IL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.87
St. Louis, MO-IL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.47
St. Louis, MO-IL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.15
St. Louis, MO-IL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.10
St. Louis, MO-IL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $259.60
St. Louis, MO-IL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.96
St. Louis, MO-IL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.70
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
St. Louis, MO-IL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $71.09
St. Louis, MO-IL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.11
St. Louis, MO-IL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $53.32
St. Louis, MO-IL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.52
St. Louis, MO-IL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.35
St. Louis, MO-IL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.14
St. Louis, MO-IL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
St. Louis, MO-IL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
St. Louis, MO-IL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
St. Louis, MO-IL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $82.67
St. Louis, MO-IL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.27
St. Louis, MO-IL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.00
St. Louis, MO-IL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $115.72
St. Louis, MO-IL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.57
St. Louis, MO-IL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $86.79
St. Louis, MO-IL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $42.00
St. Louis, MO-IL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.20
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
St. Louis, MO-IL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.50
St. Louis, MO-IL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.32
St. Louis, MO-IL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.73
St. Louis, MO-IL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.99
St. Louis, MO-IL E0156 SEAT ATTACHMENT, WALKER NU $14.78
St. Louis, MO-IL E0156 SEAT ATTACHMENT, WALKER RR $1.48
St. Louis, MO-IL E0156 SEAT ATTACHMENT, WALKER UE $11.09
St. Louis, MO-IL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.49
St. Louis, MO-IL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.95
St. Louis, MO-IL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.12
St. Louis, MO-IL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.88
St. Louis, MO-IL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.89
St. Louis, MO-IL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.16
St. Louis, MO-IL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.34
St. Louis, MO-IL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.23
St. Louis, MO-IL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.26
Stockton, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.13
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Stockton, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.71
Stockton, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.35
Stockton, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.69
Stockton, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.27
Stockton, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.02
Stockton, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $258.72
Stockton, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.87
Stockton, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.04
Stockton, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $70.45
Stockton, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.05
Stockton, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.84
Stockton, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Stockton, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Stockton, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Stockton, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Stockton, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
Stockton, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Stockton, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.64
Stockton, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.76
Stockton, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.23
Stockton, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $115.72
Stockton, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.57
Stockton, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $86.79
Stockton, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $39.60
Stockton, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.96
Stockton, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $29.70
Stockton, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $19.28
Stockton, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.93
Stockton, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.46
Stockton, CA E0156 SEAT ATTACHMENT, WALKER NU $14.50
Stockton, CA E0156 SEAT ATTACHMENT, WALKER RR $1.45
Stockton, CA E0156 SEAT ATTACHMENT, WALKER UE $10.88
Stockton, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.98
Stockton, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Stockton, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.49
Stockton, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.00
Stockton, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.00
Stockton, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.00
Stockton, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.00
Stockton, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.20
Stockton, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.00
Suffolk County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.94
Suffolk County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.19
Suffolk County CBA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.46
Suffolk County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.37
Suffolk County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.34
Suffolk County CBA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.53
Suffolk County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $242.62
Suffolk County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.26
Suffolk County CBA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $181.97
Suffolk County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $62.54
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Suffolk County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.25
Suffolk County CBA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $46.91
Suffolk County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $53.00
Suffolk County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.30
Suffolk County CBA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $39.75
Suffolk County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $350.61
Suffolk County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $35.06
Suffolk County CBA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $262.96
Suffolk County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $74.80
Suffolk County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.48
Suffolk County CBA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.10
Suffolk County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $116.26
Suffolk County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.63
Suffolk County CBA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $87.20
Suffolk County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Suffolk County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Suffolk County CBA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Suffolk County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $16.82
Suffolk County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.68
Suffolk County CBA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $12.62
Suffolk County CBA E0156 SEAT ATTACHMENT, WALKER NU $14.10
Suffolk County CBA E0156 SEAT ATTACHMENT, WALKER RR $1.41
Suffolk County CBA E0156 SEAT ATTACHMENT, WALKER UE $10.58
Suffolk County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $47.06
Suffolk County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.71
Suffolk County CBA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $35.30
Suffolk County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $17.14
Suffolk County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.71
Suffolk County CBA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.86
Suffolk County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.28
Suffolk County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.23
Suffolk County CBA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.21
Syracuse, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.41
Syracuse, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.14
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Syracuse, NY E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.06
Syracuse, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.89
Syracuse, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.29
Syracuse, NY E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.17
Syracuse, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $259.00
Syracuse, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.90
Syracuse, NY E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.25
Syracuse, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.29
Syracuse, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.73
Syracuse, NY E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.47
Syracuse, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Syracuse, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Syracuse, NY E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Syracuse, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $350.00
Syracuse, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $35.00
Syracuse, NY E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $262.50
Syracuse, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $78.35
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 224 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Syracuse, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.84
Syracuse, NY E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.76
Syracuse, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $103.32
Syracuse, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.33
Syracuse, NY E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $77.49
Syracuse, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.66
Syracuse, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.07
Syracuse, NY E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.50
Syracuse, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.63
Syracuse, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.86
Syracuse, NY E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.97
Syracuse, NY E0156 SEAT ATTACHMENT, WALKER NU $14.50
Syracuse, NY E0156 SEAT ATTACHMENT, WALKER RR $1.45
Syracuse, NY E0156 SEAT ATTACHMENT, WALKER UE $10.88
Syracuse, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.98
Syracuse, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
Syracuse, NY E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.49
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Syracuse, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.49
Syracuse, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.95
Syracuse, NY E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.62
Syracuse, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.92
Syracuse, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.29
Syracuse, NY E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.69
Tampa-St. Petersburg-Clearwater, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $40.00
Tampa-St. Petersburg-Clearwater, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.00
Tampa-St. Petersburg-Clearwater, FL E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $30.00
Tampa-St. Petersburg-Clearwater, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.25
Tampa-St. Petersburg-Clearwater, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.43
Tampa-St. Petersburg-Clearwater, FL E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.19
Tampa-St. Petersburg-Clearwater, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $239.87
Tampa-St. Petersburg-Clearwater, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.99
Tampa-St. Petersburg-Clearwater, FL E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $179.90
Tampa-St. Petersburg-Clearwater, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $62.00
Tampa-St. Petersburg-Clearwater, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.20
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Tampa-St. Petersburg-Clearwater, FL E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $46.50
Tampa-St. Petersburg-Clearwater, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $51.42
Tampa-St. Petersburg-Clearwater, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.14
Tampa-St. Petersburg-Clearwater, FL E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $38.57
Tampa-St. Petersburg-Clearwater, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $325.00
Tampa-St. Petersburg-Clearwater, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $32.50
Tampa-St. Petersburg-Clearwater, FL E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $243.75
Tampa-St. Petersburg-Clearwater, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $75.00
Tampa-St. Petersburg-Clearwater, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.50
Tampa-St. Petersburg-Clearwater, FL E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $56.25
Tampa-St. Petersburg-Clearwater, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $120.00
Tampa-St. Petersburg-Clearwater, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.00
Tampa-St. Petersburg-Clearwater, FL E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $90.00
Tampa-St. Petersburg-Clearwater, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.00
Tampa-St. Petersburg-Clearwater, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.50
Tampa-St. Petersburg-Clearwater, FL E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.25
Tampa-St. Petersburg-Clearwater, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $15.78
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Tampa-St. Petersburg-Clearwater, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.58
Tampa-St. Petersburg-Clearwater, FL E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $11.84
Tampa-St. Petersburg-Clearwater, FL E0156 SEAT ATTACHMENT, WALKER NU $13.55
Tampa-St. Petersburg-Clearwater, FL E0156 SEAT ATTACHMENT, WALKER RR $1.36
Tampa-St. Petersburg-Clearwater, FL E0156 SEAT ATTACHMENT, WALKER UE $10.16
Tampa-St. Petersburg-Clearwater, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $45.00
Tampa-St. Petersburg-Clearwater, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.50
Tampa-St. Petersburg-Clearwater, FL E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $33.75
Tampa-St. Petersburg-Clearwater, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $16.32
Tampa-St. Petersburg-Clearwater, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.63
Tampa-St. Petersburg-Clearwater, FL E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.24
Tampa-St. Petersburg-Clearwater, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.88
Tampa-St. Petersburg-Clearwater, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.19
Tampa-St. Petersburg-Clearwater, FL E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.91
Toledo, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.82
Toledo, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.28
Toledo, OH E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.12
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Toledo, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $41.89
Toledo, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.19
Toledo, OH E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.42
Toledo, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $239.61
Toledo, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.96
Toledo, OH E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $179.71
Toledo, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.75
Toledo, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.68
Toledo, OH E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.56
Toledo, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $44.48
Toledo, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.45
Toledo, OH E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $33.36
Toledo, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $337.86
Toledo, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $33.79
Toledo, OH E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $253.40
Toledo, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $69.72
Toledo, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $6.97
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Toledo, OH E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $52.29
Toledo, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $91.54
Toledo, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $9.15
Toledo, OH E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $68.66
Toledo, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $37.55
Toledo, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.76
Toledo, OH E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $28.16
Toledo, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $17.82
Toledo, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.78
Toledo, OH E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.37
Toledo, OH E0156 SEAT ATTACHMENT, WALKER NU $14.98
Toledo, OH E0156 SEAT ATTACHMENT, WALKER RR $1.50
Toledo, OH E0156 SEAT ATTACHMENT, WALKER UE $11.24
Toledo, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $45.49
Toledo, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.55
Toledo, OH E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $34.12
Toledo, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Toledo, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.80
Toledo, OH E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.50
Toledo, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $11.60
Toledo, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.16
Toledo, OH E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.70
Tucson, AZ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.80
Tucson, AZ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.58
Tucson, AZ E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.35
Tucson, AZ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.54
Tucson, AZ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.35
Tucson, AZ E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.66
Tucson, AZ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $236.00
Tucson, AZ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $23.60
Tucson, AZ E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $177.00
Tucson, AZ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $70.24
Tucson, AZ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.02
Tucson, AZ E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.68
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Tucson, AZ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.14
Tucson, AZ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.71
Tucson, AZ E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.86
Tucson, AZ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $337.50
Tucson, AZ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $33.75
Tucson, AZ E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $253.13
Tucson, AZ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $80.31
Tucson, AZ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.03
Tucson, AZ E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $60.23
Tucson, AZ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $128.16
Tucson, AZ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.82
Tucson, AZ E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $96.12
Tucson, AZ E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.50
Tucson, AZ E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.15
Tucson, AZ E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.13
Tucson, AZ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.16
Tucson, AZ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.82
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Tucson, AZ E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.62
Tucson, AZ E0156 SEAT ATTACHMENT, WALKER NU $14.00
Tucson, AZ E0156 SEAT ATTACHMENT, WALKER RR $1.40
Tucson, AZ E0156 SEAT ATTACHMENT, WALKER UE $10.50
Tucson, AZ E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $50.56
Tucson, AZ E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.06
Tucson, AZ E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.92
Tucson, AZ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.50
Tucson, AZ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.85
Tucson, AZ E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $13.88
Tucson, AZ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.31
Tucson, AZ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.23
Tucson, AZ E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.23
Tulsa, OK E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $43.82
Tulsa, OK E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.38
Tulsa, OK E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $32.87
Tulsa, OK E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.03
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Tulsa, OK E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.20
Tulsa, OK E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.52
Tulsa, OK E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $250.00
Tulsa, OK E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.00
Tulsa, OK E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $187.50
Tulsa, OK E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $67.29
Tulsa, OK E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.73
Tulsa, OK E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $50.47
Tulsa, OK E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
Tulsa, OK E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Tulsa, OK E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Tulsa, OK E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $375.72
Tulsa, OK E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.57
Tulsa, OK E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $281.79
Tulsa, OK E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.62
Tulsa, OK E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.76
Tulsa, OK E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.22
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Tulsa, OK E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $117.78
Tulsa, OK E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.78
Tulsa, OK E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $88.34
Tulsa, OK E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.22
Tulsa, OK E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.12
Tulsa, OK E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.92
Tulsa, OK E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.00
Tulsa, OK E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.80
Tulsa, OK E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.50
Tulsa, OK E0156 SEAT ATTACHMENT, WALKER NU $14.99
Tulsa, OK E0156 SEAT ATTACHMENT, WALKER RR $1.50
Tulsa, OK E0156 SEAT ATTACHMENT, WALKER UE $11.24
Tulsa, OK E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.98
Tulsa, OK E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.00
Tulsa, OK E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.49
Tulsa, OK E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.72
Tulsa, OK E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.97
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Tulsa, OK E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.79
Tulsa, OK E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.69
Tulsa, OK E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.27
Tulsa, OK E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.52
Virginia Beach-Norfolk-Newport News, VA-NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.56
Virginia Beach-Norfolk-Newport News, VA-NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.66
Virginia Beach-Norfolk-Newport News, VA-NC E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.92
Virginia Beach-Norfolk-Newport News, VA-NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $48.06
Virginia Beach-Norfolk-Newport News, VA-NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.81
Virginia Beach-Norfolk-Newport News, VA-NC E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $36.05
Virginia Beach-Norfolk-Newport News, VA-NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $259.36
Virginia Beach-Norfolk-Newport News, VA-NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $25.94
Virginia Beach-Norfolk-Newport News, VA-NC E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $194.52
Virginia Beach-Norfolk-Newport News, VA-NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $74.86
Virginia Beach-Norfolk-Newport News, VA-NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.49
Virginia Beach-Norfolk-Newport News, VA-NC E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $56.15
Virginia Beach-Norfolk-Newport News, VA-NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $55.00
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CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Virginia Beach-Norfolk-Newport News, VA-NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.50
Virginia Beach-Norfolk-Newport News, VA-NC E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $41.25
Virginia Beach-Norfolk-Newport News, VA-NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Virginia Beach-Norfolk-Newport News, VA-NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Virginia Beach-Norfolk-Newport News, VA-NC E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Virginia Beach-Norfolk-Newport News, VA-NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.80
Virginia Beach-Norfolk-Newport News, VA-NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.38
Virginia Beach-Norfolk-Newport News, VA-NC E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.85
Virginia Beach-Norfolk-Newport News, VA-NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $137.00
Virginia Beach-Norfolk-Newport News, VA-NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.70
Virginia Beach-Norfolk-Newport News, VA-NC E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $102.75
Virginia Beach-Norfolk-Newport News, VA-NC E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.87
Virginia Beach-Norfolk-Newport News, VA-NC E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.39
Virginia Beach-Norfolk-Newport News, VA-NC E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.90
Virginia Beach-Norfolk-Newport News, VA-NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $19.50
Virginia Beach-Norfolk-Newport News, VA-NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.95
Virginia Beach-Norfolk-Newport News, VA-NC E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $14.63
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 237 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Virginia Beach-Norfolk-Newport News, VA-NC E0156 SEAT ATTACHMENT, WALKER NU $15.32
Virginia Beach-Norfolk-Newport News, VA-NC E0156 SEAT ATTACHMENT, WALKER RR $1.53
Virginia Beach-Norfolk-Newport News, VA-NC E0156 SEAT ATTACHMENT, WALKER UE $11.49
Virginia Beach-Norfolk-Newport News, VA-NC E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $54.62
Virginia Beach-Norfolk-Newport News, VA-NC E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.46
Virginia Beach-Norfolk-Newport News, VA-NC E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $40.97
Virginia Beach-Norfolk-Newport News, VA-NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.27
Virginia Beach-Norfolk-Newport News, VA-NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.03
Virginia Beach-Norfolk-Newport News, VA-NC E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.20
Virginia Beach-Norfolk-Newport News, VA-NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.25
Virginia Beach-Norfolk-Newport News, VA-NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.33
Virginia Beach-Norfolk-Newport News, VA-NC E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.94
Visalia-Porterville, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $54.88
Visalia-Porterville, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $5.49
Visalia-Porterville, CA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $41.16
Visalia-Porterville, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $42.52
Visalia-Porterville, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.25
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 238 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Visalia-Porterville, CA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $31.89
Visalia-Porterville, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $283.10
Visalia-Porterville, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $28.31
Visalia-Porterville, CA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $212.33
Visalia-Porterville, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $73.50
Visalia-Porterville, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.35
Visalia-Porterville, CA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $55.13
Visalia-Porterville, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $54.50
Visalia-Porterville, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.45
Visalia-Porterville, CA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $40.88
Visalia-Porterville, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $369.06
Visalia-Porterville, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.91
Visalia-Porterville, CA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $276.80
Visalia-Porterville, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.80
Visalia-Porterville, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.48
Visalia-Porterville, CA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.60
Visalia-Porterville, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $117.39
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 239 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Visalia-Porterville, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $11.74
Visalia-Porterville, CA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $88.04
Visalia-Porterville, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.82
Visalia-Porterville, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.08
Visalia-Porterville, CA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.62
Visalia-Porterville, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $20.50
Visalia-Porterville, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $2.05
Visalia-Porterville, CA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $15.38
Visalia-Porterville, CA E0156 SEAT ATTACHMENT, WALKER NU $14.16
Visalia-Porterville, CA E0156 SEAT ATTACHMENT, WALKER RR $1.42
Visalia-Porterville, CA E0156 SEAT ATTACHMENT, WALKER UE $10.62
Visalia-Porterville, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $56.85
Visalia-Porterville, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.69
Visalia-Porterville, CA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $42.64
Visalia-Porterville, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $21.00
Visalia-Porterville, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.10
Visalia-Porterville, CA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.75
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 240 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Visalia-Porterville, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.34
Visalia-Porterville, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.33
Visalia-Porterville, CA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.01
Washington-Arlington-Alexandria, DC-VA-MD-WV E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.12
Washington-Arlington-Alexandria, DC-VA-MD-WV E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.71
Washington-Arlington-Alexandria, DC-VA-MD-WV E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.34
Washington-Arlington-Alexandria, DC-VA-MD-WV E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $47.64
Washington-Arlington-Alexandria, DC-VA-MD-WV E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.76
Washington-Arlington-Alexandria, DC-VA-MD-WV E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $35.73
Washington-Arlington-Alexandria, DC-VA-MD-WV E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $262.86
Washington-Arlington-Alexandria, DC-VA-MD-WV E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $26.29
Washington-Arlington-Alexandria, DC-VA-MD-WV E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $197.15
Washington-Arlington-Alexandria, DC-VA-MD-WV E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $72.54
Washington-Arlington-Alexandria, DC-VA-MD-WV E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.25
Washington-Arlington-Alexandria, DC-VA-MD-WV E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $54.41
Washington-Arlington-Alexandria, DC-VA-MD-WV E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.64
Washington-Arlington-Alexandria, DC-VA-MD-WV E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.76
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 241 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Washington-Arlington-Alexandria, DC-VA-MD-WV E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $43.23
Washington-Arlington-Alexandria, DC-VA-MD-WV E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Washington-Arlington-Alexandria, DC-VA-MD-WV E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Washington-Arlington-Alexandria, DC-VA-MD-WV E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Washington-Arlington-Alexandria, DC-VA-MD-WV E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $83.42
Washington-Arlington-Alexandria, DC-VA-MD-WV E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.34
Washington-Arlington-Alexandria, DC-VA-MD-WV E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $62.57
Washington-Arlington-Alexandria, DC-VA-MD-WV E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $136.25
Washington-Arlington-Alexandria, DC-VA-MD-WV E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $13.63
Washington-Arlington-Alexandria, DC-VA-MD-WV E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $102.19
Washington-Arlington-Alexandria, DC-VA-MD-WV E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $41.74
Washington-Arlington-Alexandria, DC-VA-MD-WV E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.17
Washington-Arlington-Alexandria, DC-VA-MD-WV E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $31.31
Washington-Arlington-Alexandria, DC-VA-MD-WV E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $20.50
Washington-Arlington-Alexandria, DC-VA-MD-WV E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $2.05
Washington-Arlington-Alexandria, DC-VA-MD-WV E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $15.38
Washington-Arlington-Alexandria, DC-VA-MD-WV E0156 SEAT ATTACHMENT, WALKER NU $15.43
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 242 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Washington-Arlington-Alexandria, DC-VA-MD-WV E0156 SEAT ATTACHMENT, WALKER RR $1.54
Washington-Arlington-Alexandria, DC-VA-MD-WV E0156 SEAT ATTACHMENT, WALKER UE $11.57
Washington-Arlington-Alexandria, DC-VA-MD-WV E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $49.54
Washington-Arlington-Alexandria, DC-VA-MD-WV E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.95
Washington-Arlington-Alexandria, DC-VA-MD-WV E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $37.16
Washington-Arlington-Alexandria, DC-VA-MD-WV E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $18.98
Washington-Arlington-Alexandria, DC-VA-MD-WV E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.90
Washington-Arlington-Alexandria, DC-VA-MD-WV E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.24
Washington-Arlington-Alexandria, DC-VA-MD-WV E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.80
Washington-Arlington-Alexandria, DC-VA-MD-WV E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.28
Washington-Arlington-Alexandria, DC-VA-MD-WV E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.60
Wichita, KS E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $46.40
Wichita, KS E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.64
Wichita, KS E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $34.80
Wichita, KS E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.21
Wichita, KS E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.52
Wichita, KS E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.91
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 243 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Wichita, KS E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $248.53
Wichita, KS E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $24.85
Wichita, KS E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $186.40
Wichita, KS E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $69.66
Wichita, KS E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $6.97
Wichita, KS E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $52.25
Wichita, KS E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $57.00
Wichita, KS E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.70
Wichita, KS E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.75
Wichita, KS E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $377.86
Wichita, KS E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $37.79
Wichita, KS E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $283.40
Wichita, KS E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $84.64
Wichita, KS E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $8.46
Wichita, KS E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $63.48
Wichita, KS E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $126.39
Wichita, KS E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.64
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 244 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Wichita, KS E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $94.79
Wichita, KS E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $43.50
Wichita, KS E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.35
Wichita, KS E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $32.63
Wichita, KS E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.32
Wichita, KS E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.83
Wichita, KS E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.74
Wichita, KS E0156 SEAT ATTACHMENT, WALKER NU $15.75
Wichita, KS E0156 SEAT ATTACHMENT, WALKER RR $1.58
Wichita, KS E0156 SEAT ATTACHMENT, WALKER UE $11.81
Wichita, KS E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $47.64
Wichita, KS E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.76
Wichita, KS E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $35.73
Wichita, KS E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $19.36
Wichita, KS E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.94
Wichita, KS E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $14.52
Wichita, KS E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $12.34
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 245 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Worcester, MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $45.32
Wichita, KS E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.23
Wichita, KS E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $9.26
Worcester, MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.53
Worcester, MA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.99
Worcester, MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $44.93
Worcester, MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $4.49
Worcester, MA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $33.70
Worcester, MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $279.36
Worcester, MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $27.94
Worcester, MA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $209.52
Worcester, MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $71.14
Worcester, MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $7.11
Worcester, MA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $53.36
Worcester, MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.50
Worcester, MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.65
Worcester, MA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.38
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 246 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Worcester, MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $360.36
Worcester, MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $36.04
Worcester, MA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $270.27
Worcester, MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $77.38
Worcester, MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $7.74
Worcester, MA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $58.04
Worcester, MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $123.12
Worcester, MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $12.31
Worcester, MA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $92.34
Worcester, MA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $40.00
Worcester, MA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $4.00
Worcester, MA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $30.00
Worcester, MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $18.32
Worcester, MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.83
Worcester, MA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $13.74
Worcester, MA E0156 SEAT ATTACHMENT, WALKER NU $14.25
Worcester, MA E0156 SEAT ATTACHMENT, WALKER RR $1.43
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 247 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Worcester, MA E0156 SEAT ATTACHMENT, WALKER UE $10.69
Worcester, MA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $54.99
Worcester, MA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $5.50
Worcester, MA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $41.24
Worcester, MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $20.86
Worcester, MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $2.09
Worcester, MA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $15.65
Worcester, MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $13.34
Worcester, MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.33
Worcester, MA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $10.01
Youngstown-Warren-Boardman, OH-PA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $37.25
Youngstown-Warren-Boardman, OH-PA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.73
Youngstown-Warren-Boardman, OH-PA E0130 WALKER, RIGID (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $27.94
Youngstown-Warren-Boardman, OH-PA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT NU $38.64
Youngstown-Warren-Boardman, OH-PA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT RR $3.86
Youngstown-Warren-Boardman, OH-PA E0135 WALKER, FOLDING (PICKUP), ADJUSTABLE OR FIXED HEIGHT UE $28.98
Youngstown-Warren-Boardman, OH-PA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE NU $218.25
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 248 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Youngstown-Warren-Boardman, OH-PA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE RR $21.83
Youngstown-Warren-Boardman, OH-PA E0140 WALKER, WITH TRUNK SUPPORT, ADJUSTABLE OR FIXED HEIGHT, ANY TYPE UE $163.69
Youngstown-Warren-Boardman, OH-PA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $56.75
Youngstown-Warren-Boardman, OH-PA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $5.68
Youngstown-Warren-Boardman, OH-PA E0141 WALKER, RIGID, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $42.56
Youngstown-Warren-Boardman, OH-PA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT NU $45.00
Youngstown-Warren-Boardman, OH-PA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT RR $4.50
Youngstown-Warren-Boardman, OH-PA E0143 WALKER, FOLDING, WHEELED, ADJUSTABLE OR FIXED HEIGHT UE $33.75
Youngstown-Warren-Boardman, OH-PA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE NU $280.85
Youngstown-Warren-Boardman, OH-PA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE RR $28.09
Youngstown-Warren-Boardman, OH-PA E0147 WALKER, HEAVY DUTY, MULTIPLE BRAKING SYSTEM, VARIABLE WHEEL RESISTANCE UE $210.64
Youngstown-Warren-Boardman, OH-PA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH NU $66.15
Youngstown-Warren-Boardman, OH-PA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH RR $6.62
Youngstown-Warren-Boardman, OH-PA E0148 WALKER, HEAVY DUTY, WITHOUT WHEELS, RIGID OR FOLDING, ANY TYPE, EACH UE $49.61
Youngstown-Warren-Boardman, OH-PA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE NU $100.46
Youngstown-Warren-Boardman, OH-PA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE RR $10.05
Youngstown-Warren-Boardman, OH-PA E0149 WALKER, HEAVY DUTY, WHEELED, RIGID OR FOLDING, ANY TYPE UE $75.35
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 249 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Youngstown-Warren-Boardman, OH-PA E0154 PLATFORM ATTACHMENT, WALKER, EACH NU $35.46
Youngstown-Warren-Boardman, OH-PA E0154 PLATFORM ATTACHMENT, WALKER, EACH RR $3.55
Youngstown-Warren-Boardman, OH-PA E0154 PLATFORM ATTACHMENT, WALKER, EACH UE $26.60
Youngstown-Warren-Boardman, OH-PA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR NU $15.10
Youngstown-Warren-Boardman, OH-PA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR RR $1.51
Youngstown-Warren-Boardman, OH-PA E0155 WHEEL ATTACHMENT, RIGID PICK-UP WALKER, PER PAIR UE $11.33
Youngstown-Warren-Boardman, OH-PA E0156 SEAT ATTACHMENT, WALKER NU $13.08
Youngstown-Warren-Boardman, OH-PA E0156 SEAT ATTACHMENT, WALKER RR $1.31
Youngstown-Warren-Boardman, OH-PA E0156 SEAT ATTACHMENT, WALKER UE $9.81
Youngstown-Warren-Boardman, OH-PA E0157 CRUTCH ATTACHMENT, WALKER, EACH NU $40.02
Youngstown-Warren-Boardman, OH-PA E0157 CRUTCH ATTACHMENT, WALKER, EACH RR $4.00
Youngstown-Warren-Boardman, OH-PA E0157 CRUTCH ATTACHMENT, WALKER, EACH UE $30.02
Youngstown-Warren-Boardman, OH-PA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) NU $16.36
Youngstown-Warren-Boardman, OH-PA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) RR $1.64
Youngstown-Warren-Boardman, OH-PA E0158 LEG EXTENSIONS FOR WALKER, PER SET OF FOUR (4) UE $12.27
Youngstown-Warren-Boardman, OH-PA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH NU $10.80
Youngstown-Warren-Boardman, OH-PA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH RR $1.08
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 250 of 251
CBA NameHCPCSCode HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Walkers and Related Accessories
Youngstown-Warren-Boardman, OH-PA E0159 BRAKE ATTACHMENT FOR WHEELED WALKER, REPLACEMENT, EACH UE $8.10
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 251 of 251
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