HCPCS Level II E0272: Mattress, Foam Rubber

HCPCS Level II code E0272 describes a foam rubber mattress used as durable medical equipment for patients requiring pressure redistribution or basic bedding replacement; the service is durable medical equipment (DME) typically provided for use in the patient’s home or long-term care setting and billed when a qualifying medical need for a foam rubber mattress is documented.

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HCPCS Level II E0272: Mattress, Foam Rubber

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Get alerted when payer policies referencing E0272 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A homebound adult with limited mobility and risk of pressure injury is evaluated by a primary care physician or wound care specialist. The clinician documents medical necessity for a pressure-relieving surface due to conditions such as stage 2 pressure ulcer on the sacrum, chronic immobility from advanced neurologic disease, or severe rheumatoid arthritis limiting repositioning. The prescription for a foam mattress (E0272) is written by the treating clinician and forwarded to a durable medical equipment (DME) supplier. The DME supplier verifies patient eligibility with the payor (Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, Medicare), obtains prior authorization if required, arranges delivery to the patient’s residence or long-term care facility, and provides basic patient education on mattress use and maintenance. Follow-up occurs with the ordering clinician and wound care team to assess skin integrity and therapy effectiveness, with documentation of continued medical necessity for ongoing coverage if the mattress remains required.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99304`	Initial nursing facility care, per day, for evaluation and management of a patient	Pre-supply assessment and documentation in the facility setting to establish medical necessity for a foam mattress.
`99341`	Home visit for the evaluation and management of a new patient	Home assessment visit that can support the prescription and medical necessity documentation for `E0272`.
`97597`	Debridement (selective) of open wounds; first 20 sq cm or less	Wound care procedures that often occur alongside provision of pressure-relieving mattresses for ulcer management.
`99406`	Smoking and tobacco use cessation counseling; intermediate, greater than 3 minutes up to 10 minutes	Ancillary counseling services that may be provided during visits addressing overall wound healing environment.
`99499`	Unlisted evaluation and management service	Use for complex, non-standard evaluation services related to durable medical equipment prescription when no other E/M code fits.

Related Modifiers

5 rows

Modifier	Description	When to Use
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207ZC0008X	Clinical Informatics (Pathology) Physician	Physicians who practice Clinical Informatics collaborate with other health care and information technology professionals to analyze, design, implement…
246QC1000X	Chemistry Pathology Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
111NX0100X	Occupational Health Chiropractor	Occupational Health is that specialty within the chiropractic profession that deals with the prevention and management of work related injuries. It al…
207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the labora…

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
E10.9	Type 1 diabetes mellitus without complications
E11.9	Type 2 diabetes mellitus without complications
G60.9	Hereditary and idiopathic neuropathy, unspecified
G81.90	Hemiplegia, unspecified affecting unspecified side
G83.4	Cauda equina syndrome
I69.391	Dysphagia following cerebral infarction
I69.398	Other sequelae of cerebral infarction
M15.0	Primary generalized (osteo)arthritis
M17.11	Unilateral primary osteoarthritis, right knee
M17.12	Unilateral primary osteoarthritis, left knee

Showing 1–10 of 25

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS Level II E0112: Underarm Wooden Crutches, Pair

HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

HCPCS E0118: Crutch Substitute, Lower Leg Platform

Showing 1–10 of 670

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99304`	Initial nursing facility care, per day, for evaluation and management of a patient	Pre-supply assessment and documentation in the facility setting to establish medical necessity for a foam mattress.
`99341`	Home visit for the evaluation and management of a new patient	Home assessment visit that can support the prescription and medical necessity documentation for `E0272`.
`97597`	Debridement (selective) of open wounds; first 20 sq cm or less	Wound care procedures that often occur alongside provision of pressure-relieving mattresses for ulcer management.
`99406`	Smoking and tobacco use cessation counseling; intermediate, greater than 3 minutes up to 10 minutes	Ancillary counseling services that may be provided during visits addressing overall wound healing environment.
`99499`	Unlisted evaluation and management service	Use for complex, non-standard evaluation services related to durable medical equipment prescription when no other E/M code fits.

Related Modifiers

5 rows

Modifier	Description	When to Use
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
79	Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…	- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
251B00000X	Case Management Agency	An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
207RH0000X	Hematology (Internal Medicine) Physician	An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207ZC0008X	Clinical Informatics (Pathology) Physician	Physicians who practice Clinical Informatics collaborate with other health care and information technology professionals to analyze, design, implement…
246QC1000X	Chemistry Pathology Specialist/Technologist	Technologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Pathology
111NX0100X	Occupational Health Chiropractor	Occupational Health is that specialty within the chiropractic profession that deals with the prevention and management of work related injuries. It al…
207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the labora…

Related ICD-10-CM Codes

25 rows

ICD-10-CM Code	Description
E10.9	Type 1 diabetes mellitus without complications
E11.9	Type 2 diabetes mellitus without complications
G60.9	Hereditary and idiopathic neuropathy, unspecified
G81.90	Hemiplegia, unspecified affecting unspecified side
G83.4	Cauda equina syndrome
I69.391	Dysphagia following cerebral infarction
I69.398	Other sequelae of cerebral infarction
M15.0	Primary generalized (osteo)arthritis
M17.11	Unilateral primary osteoarthritis, right knee
M17.12	Unilateral primary osteoarthritis, left knee

Showing 1–10 of 25

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

HCPCS-E0105-CANE-QUAD-THREE-PRONG-MOBILITY-AID

HCPCS Level II E0105: Cane, Quad or Three-Prong, Includes Tips

HCPCS-E0110-FOREARM-CRUTCHES-PAIR-DME-MOBILITY

HCPCS Level II E0110: Forearm Crutches, Pair, Complete with Tips and Handgrips

HCPCS-E0111-CRUTCH-FOREARM-DURABLE-MEDICAL-EQUIPMENT

HCPCS Level II E0111: Crutch, Forearm, With Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS Level II E0112: Underarm Wooden Crutches, Pair

HCPCS-E0113-CRUTCH-UNDERARM-WOOD-ADJUSTABLE-FIXED-WITH-PAD-TIP-HANDGRIP

HCPCS Level II E0113: Crutch Underarm, Wood, Adjustable or Fixed

HCPCS-E0114-UNDERARM-CRUTCHES-PAIR-ADJUSTABLE-FIXED

HCPCS Level II E0114: Underarm (Axillary) Crutches, Adjustable or Fixed, Pair

HCPCS-E0116-UNDERARM-CRUTCH-NON-WOOD-ADJUSTABLE-FIXED

HCPCS E0116: Underarm Crutch, Non-Wood, Adjustable/Fixed with Pad

HCPCS-E0117-ARTICULATING-SPRING-ASSISTED-UNDERARM-CRUTCH

HCPCS Level II E0117: Crutch, Underarm, Articulating, Spring-Assisted

HCPCS-E0118-LOWER-LEG-PLATFORM-CRUTCH-SUBSTITUTE

HCPCS E0118: Crutch Substitute, Lower Leg Platform

Showing 1–10 of 670

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS Level II E0272: Mattress, Foam Rubber

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OpenPayer

HCPCS Level II E0272: Mattress, Foam Rubber

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

HCPCS Level II E0272: Mattress, Foam Rubber

Sign up for hcpcs E0272 policy alerts

HCPCS Level II E0272: Mattress, Foam Rubber

Sign up for hcpcs E0272 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What does HCPCS code E0272 cover and when is it used?

Who prescribes E0272 and what are the steps to obtain the mattress?

Which modifiers are relevant when billing E0272 and when should they be used?

What related CPT codes should be billed alongside E0272 to support medical necessity?

Which payers cover E0272 and does prior authorization apply?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What does HCPCS code E0272 cover and when is it used?

Who prescribes E0272 and what are the steps to obtain the mattress?

Which modifiers are relevant when billing E0272 and when should they be used?

What related CPT codes should be billed alongside E0272 to support medical necessity?

Which payers cover E0272 and does prior authorization apply?

References