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HCPCS E0277: Powered Pressure-Reducing Air Mattress

HCPCS Level II code E0277 identifies a powered pressure-reducing air mattress, classified as durable medical equipment used to manage and prevent pressure injuries in patients requiring ongoing support. Nationally, this code matters for clinicians, DME suppliers, and payers because powered therapeutic surfaces represent a frequent and often costly component of long-term wound and immobility management.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for use of a powered pressure-reducing air mattress, common settings of service such as home health and long-term care facilities, and typical billing considerations for DME supply. The publication outlines benchmark themes relevant to reimbursement and coverage, summarizes policy developments that affect authorization and documentation requirements, and highlights coding and service-line context needed for accurate claim submission.

This executive summary is intended to orient clinicians, billing professionals, and policy analysts to the clinical purpose of E0277, the primary payers engaged in coverage decisions, and the types of operational and policy information presented in the full publication.

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Billing Code Overview

HCPCS Level II code E0277 describes a powered pressure-reducing air mattress. This supply is used to provide therapeutic pressure redistribution for patients at risk of, or with existing, pressure ulcers or other pressure-related skin conditions. The service type is durable medical equipment (DME) and the typical site of service is home or long-term care facility, where a powered mattress system supports ongoing pressure management needs.

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HCPCS E0277: Powered Pressure-Reducing Air Mattress

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Billing Code Overview

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult or geriatric individual with significant immobility, high risk for pressure injuries, or existing stage I–IV pressure ulcers who requires a powered pressure-reducing air mattress for ongoing pressure redistribution and skin protection. Common scenarios include a homebound patient recently discharged after a prolonged hospitalization for stroke with hemiparesis, a spinal cord injury patient with paraplegia requiring long-term support surfaces, or a nursing home resident with advanced frailty and recurrent skin breakdown.

The clinical workflow begins with a clinician assessment (primary care physician, hospitalist, wound care specialist, or rehabilitation physician) documenting impaired mobility, risk assessment results (e.g., Braden Scale score), or an active pressure ulcer that meets coverage criteria for a powered pressure-reducing air mattress. An order for durable medical equipment for a powered mattress (E0277) is written specifying size, medical necessity, and expected duration. A DME supplier evaluates the home environment, obtains prior authorization if required by the payor, delivers and sets up the mattress, and provides patient/caregiver training on operation and skin monitoring. Follow-up visits or home health nurse assessments document continued need, skin status, and any equipment issues. Documentation typically includes diagnosis codes supporting medical necessity, objective risk assessments, physician orders, and supplier delivery notes.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when additional effort or complexity is documented for mattress setup or customization beyond usual delivery (rare for DME).
`26`	Professional component	Use when billing for physician professional services separately from DME supplier services (e.g., evaluation for DME).
`52`	Reduced services	Use if a partial or temporary solution was provided instead of the full ordered mattress.
`53`	Discontinued procedure	Use if mattress delivery or setup was initiated but discontinued for documented patient-related reasons.
`62`	Two surgeons	Use when two separate clinicians from different specialties share responsibility for the care plan related to pressure management.
`78`	Return to the operating room	Use if a related surgical procedure occurs and subsequent mattress needs change and are billed in proximity to that event.
`80`	Assistant at surgery	Use when an assistant surgeon is billed for a related operative procedure impacting postoperative support surface needs.
`82`	Assistant (when qualified resident not available)	Use under circumstances where an assistant surgeon is required for a related procedure and is billed.
`RR`	Recovery room services by CRNA	Use when an anesthetist bills related perioperative services that affect immediate mattress requirements.
`UE`	Service furnished in emergency/urgent care	Use when mattress provision is billed in an emergency or urgent care context.

Taxonomy Code	Specialty	Notes
`2080P0208X`	Physical Medicine & Rehabilitation	Physicians managing mobility, pressure injury prevention, and DME orders.
`207R00000X`	Family Medicine	Primary care clinicians who commonly order support surfaces for homebound patients.
`207L00000X`	Internal Medicine	Hospitalists and internists documenting medical necessity during discharge planning.
`3336S0004X`	Wound Care Nurse Specialist	Clinicians providing wound assessment and recommendations for support surfaces.
`261QM0800X`	Home Health Agency	Agencies coordinating delivery, setup, and in-home assessments by nurses.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z74.01`	Bed confinement status	Indicates limited mobility and need for a powered pressure-reducing mattress to prevent pressure injuries.
`Z74.09`	Other reduced mobility	Documents generalized immobility contributing to risk of skin breakdown requiring support surface.
`L89.152`	Pressure ulcer of sacral region, stage III	Active pressure ulcer where a powered mattress is medically necessary for offloading and healing.
`L89.154`	Pressure ulcer of sacral region, stage IV	Severe pressure injury requiring advanced support surfaces as part of management.
`G82.20`	Paraplegia, unspecified	Neurologic immobility condition frequently associated with need for therapeutic mattress.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	Used when a clinician documents medical necessity, performs risk assessment, and orders the powered mattress.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate	May be used if counseling is part of comprehensive care impacting wound healing and risk management in the same episode of care.
`97597`	Debridement, selective debridement for wound(s); without anesthesia, first 20 sq cm or less	Performed by wound care clinicians for pressure ulcer management preceding or concurrent with ordering a therapeutic mattress.
`11042`	Debridement, subcutaneous tissue, first 20 sq cm or less	Surgical debridement code that may occur before mattress prescription in advanced pressure injury care.
`99512`	Home visit for newborn under 28 days of age	Data not applicable to typical adult scenarios; included here only if pediatric powered mattress needs are documented.

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

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

HCPCS E0105: Cane, Quad or Three Prong, Adjustable or Fixed

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

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

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

HCPCS E0111: Crutch Forearm, Includes Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS E0112: Underarm Wooden Crutches, Pair, with Pads and Handgrips

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

HCPCS Level II E0113: Crutch Underarm, Wood, with Pad, Tip and Handgrip

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

HCPCS E0114: Underarm Crutches, Non-Wood, Pair, Adjustable or Fixed

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

HCPCS E0116: Underarm Crutch, Non‑Wood, Adjustable or Fixed

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

HCPCS E0117: Articulating, Spring-Assisted Underarm Crutch

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

HCPCS E0118: Lower Leg Platform Crutch Substitute

Showing 1–10 of 670

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when additional effort or complexity is documented for mattress setup or customization beyond usual delivery (rare for DME).
`26`	Professional component	Use when billing for physician professional services separately from DME supplier services (e.g., evaluation for DME).
`52`	Reduced services	Use if a partial or temporary solution was provided instead of the full ordered mattress.
`53`	Discontinued procedure	Use if mattress delivery or setup was initiated but discontinued for documented patient-related reasons.
`62`	Two surgeons	Use when two separate clinicians from different specialties share responsibility for the care plan related to pressure management.
`78`	Return to the operating room	Use if a related surgical procedure occurs and subsequent mattress needs change and are billed in proximity to that event.
`80`	Assistant at surgery	Use when an assistant surgeon is billed for a related operative procedure impacting postoperative support surface needs.
`82`	Assistant (when qualified resident not available)	Use under circumstances where an assistant surgeon is required for a related procedure and is billed.
`RR`	Recovery room services by CRNA	Use when an anesthetist bills related perioperative services that affect immediate mattress requirements.
`UE`	Service furnished in emergency/urgent care	Use when mattress provision is billed in an emergency or urgent care context.

Taxonomy Code	Specialty	Notes
`2080P0208X`	Physical Medicine & Rehabilitation	Physicians managing mobility, pressure injury prevention, and DME orders.
`207R00000X`	Family Medicine	Primary care clinicians who commonly order support surfaces for homebound patients.
`207L00000X`	Internal Medicine	Hospitalists and internists documenting medical necessity during discharge planning.
`3336S0004X`	Wound Care Nurse Specialist	Clinicians providing wound assessment and recommendations for support surfaces.
`261QM0800X`	Home Health Agency	Agencies coordinating delivery, setup, and in-home assessments by nurses.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z74.01`	Bed confinement status	Indicates limited mobility and need for a powered pressure-reducing mattress to prevent pressure injuries.
`Z74.09`	Other reduced mobility	Documents generalized immobility contributing to risk of skin breakdown requiring support surface.
`L89.152`	Pressure ulcer of sacral region, stage III	Active pressure ulcer where a powered mattress is medically necessary for offloading and healing.
`L89.154`	Pressure ulcer of sacral region, stage IV	Severe pressure injury requiring advanced support surfaces as part of management.
`G82.20`	Paraplegia, unspecified	Neurologic immobility condition frequently associated with need for therapeutic mattress.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99214`	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	Used when a clinician documents medical necessity, performs risk assessment, and orders the powered mattress.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate	May be used if counseling is part of comprehensive care impacting wound healing and risk management in the same episode of care.
`97597`	Debridement, selective debridement for wound(s); without anesthesia, first 20 sq cm or less	Performed by wound care clinicians for pressure ulcer management preceding or concurrent with ordering a therapeutic mattress.
`11042`	Debridement, subcutaneous tissue, first 20 sq cm or less	Surgical debridement code that may occur before mattress prescription in advanced pressure injury care.
`99512`	Home visit for newborn under 28 days of age	Data not applicable to typical adult scenarios; included here only if pediatric powered mattress needs are documented.

HCPCS E0100: Cane, Adjustable or Fixed, With Tip

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

HCPCS E0105: Cane, Quad or Three Prong, Adjustable or Fixed

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

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

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

HCPCS E0111: Crutch Forearm, Includes Tip and Handgrips

HCPCS-E0112-UNDERARM-WOOD-CRUTCHES-PAIR

HCPCS E0112: Underarm Wooden Crutches, Pair, with Pads and Handgrips

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

HCPCS Level II E0113: Crutch Underarm, Wood, with Pad, Tip and Handgrip

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

HCPCS E0114: Underarm Crutches, Non-Wood, Pair, Adjustable or Fixed

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

HCPCS E0116: Underarm Crutch, Non‑Wood, Adjustable or Fixed

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

HCPCS E0117: Articulating, Spring-Assisted Underarm Crutch

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

HCPCS E0118: Lower Leg Platform Crutch Substitute

Showing 1–10 of 670

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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

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HCPCS E0277: Powered Pressure-Reducing Air Mattress

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Billing Code Overview

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HCPCS E0277: Powered Pressure-Reducing Air Mattress

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

HCPCS E0277: Powered Pressure-Reducing Air Mattress

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Billing Code Overview

HCPCS E0277: Powered Pressure-Reducing Air Mattress

Sign up for hcpcs E0277 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code E0277 represent and where is it typically used?

What documentation and clinical workflow are needed to support medical necessity for E0277?

Which ICD-10 diagnosis codes are commonly used to justify E0277?

What CPT codes are commonly associated with the clinical scenario for E0277?

Which billing modifiers are mentioned for use with E0277 and what do they indicate?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code E0277 represent and where is it typically used?

What documentation and clinical workflow are needed to support medical necessity for E0277?

Which ICD-10 diagnosis codes are commonly used to justify E0277?

What CPT codes are commonly associated with the clinical scenario for E0277?

Which billing modifiers are mentioned for use with E0277 and what do they indicate?

References