K0827 Power Wheelchair HCPCS — Reimbursement Benchmarks | OpenPayer

Summary & Overview

HCPCS K0827: Power Wheelchair, Very Heavy Duty, 451–600 lb

HCPCS Level II code K0827 designates a very heavy-duty power wheelchair (group 2) with a captain's chair and patient weight capacity of 451 to 600 pounds. This equipment classification matters nationally because it addresses mobility needs for individuals with high body weight who require powered mobility solutions, and it affects coverage determination, supplier provisioning, and supply chain planning across payers. The code is used when billing for the device itself and associated delivery and setup services.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of how K0827 fits into durable medical equipment billing, the clinical and operational context for prescribing and supplying very heavy-duty power wheelchairs, and the typical sites of service where these devices are provided. The publication summarizes coverage considerations, common modifiers used with the service line, and where to look for additional policy guidance.

This summary is intended for clinicians, DME suppliers, compliance officers, and policy analysts seeking a national-level briefing on the code’s purpose, payer landscape, and practical implications for documenting and billing these high-capacity power mobility devices.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareK0827HCPCS Level IIpower wheelchairdurable medical equipmentmobility devicevery heavy dutycaptain chairwheelchair billingDME policy

Billing Code Overview

HCPCS Level II code K0827 describes a power wheelchair, group 2 very heavy duty, captain's chair, patient weight capacity 451 to 600 pounds. This device is classified as a durable medical equipment (power mobility device) intended for patients requiring high-capacity seating and powered mobility support.

Service type: Durable medical equipment — power wheelchair provision and delivery
Typical site of service: Durable medical equipment supplier, patient residence, or other non-acute outpatient settings where mobility devices are delivered and set up

Clinical & Coding Specifications

Clinical Context

A common scenario involves an adult patient with morbid obesity and limited mobility due to severe osteoarthritis and chronic lower-extremity weakness who requires a power wheelchair with very heavy-duty capacity. The durable medical equipment (DME) supplier receives a prescription from a physician (typically a physiatrist, orthopedic surgeon, or primary care physician) specifying a power wheelchair, group 2 very heavy duty, captain's chair, with patient weight capacity of 451 to 600 pounds (K0827).

The clinical workflow begins with a face-to-face evaluation by a qualified clinician documenting functional limitations, mobility needs, home environment, and measurements supporting the need for a bariatric power wheelchair. The clinician documents activities of daily living (ADLs) impairments (for example, inability to ambulate household distances, transfer limitations), and the necessity for a powered mobility device rather than a manual wheelchair. The supplier conducts a home assessment if required, configures seat and controls (captain's chair, seating depth/width, weight capacity 451–600 lb), and obtains any needed prior authorization from payors. Delivery includes user training, a demonstration of controls, and setup for safe transfers. Follow-up visits address repairs, adjustments, or documentation for medical necessity renewal. Typical sites of service are the DME supplier location, the patient’s home for delivery and setup, and outpatient clinics for the prescribing evaluation.

Coding Specifications

Modifier	Description	When to Use

HCPCS K0849: Power Wheelchair, Group 3 Captain's Chair, ≤300 lb

HCPCS-K0005-ULTRALIGHTWEIGHT-WHEELCHAIR

HCPCS K0005: Ultralightweight Wheelchair

HCPCS-K0900-CUSTOMIZED-DURABLE-MEDICAL-EQUIPMENT

HCPCS K0900: Customized Durable Medical Equipment, Non-Wheelchair

HCPCS-K0870-POWER-WHEELCHAIR-HEAVY-DUTY-301-450-LB-CAPACITY

HCPCS K0870: Power Wheelchair, Heavy Duty, 301–450 lb

HCPCS-K0878-POWER-WHEELCHAIR-GROUP-4-STANDARD-300-LB-CAPACITY

HCPCS K0878: Power Wheelchair Group 4 Standard, Captain's Chair, up to 300 lb

HCPCS-K0848-POWER-WHEELCHAIR-GROUP-3-STANDARD-300LB-CAPACITY

HCPCS Level II K0848: Power Wheelchair Group 3, Sling/Solid Seat, 300 lb Capacity

HCPCS-K0864-POWER-WHEELCHAIR-EXTRA-HEAVY-DUTY-601LBS-PLUS

HCPCS Level II K0864: Power Wheelchair, Extra Heavy Duty, 601+ lbs

HCPCS-K0672-LOWER-EXTREMITY-ORTHOSIS-REMOVABLE-SOFT-INTERFACE-REPLACEMENT

HCPCS K0672: Lower Extremity Orthosis Removable Soft Interface, Replacement

HCPCS-K0013-CUSTOM-MOTORIZED-POWER-WHEELCHAIR-BASE

HCPCS K0013: Custom Motorized/Power Wheelchair Base

HCPCS-K0886-POWER-WHEELCHAIR-GROUP-4-HEAVY-DUTY-301-450-LBS

HCPCS K0886: Power Wheelchair, Group 4 Heavy Duty, 301–450 lb Capacity

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Taxonomy Code	Specialty	Notes
`261QM0800X`	Physical Medicine & Rehabilitation (Physiatry)	Common prescriber for mobility evaluations and DME justification.
`207R00000X`	Orthopedic Surgery	Prescribes wheelchairs for patients with orthopedic limitations and weight-bearing restrictions.
`243Z00000X`	Family Medicine	Primary care providers who evaluate overall medical necessity for DME.
`208000000X`	Physical Therapist	Performs mobility assessments and seat/positioning recommendations (may not independently prescribe DME in all jurisdictions).
`193200000X`	Occupational Therapist	Performs ADL and seating assessments relevant to wheelchair configuration and captain's chair needs.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E66.01`	Morbid (severe) obesity due to excess calories	Common indication for bariatric power wheelchairs given high body weight and mobility limitations.
`M16.11`	Unilateral primary osteoarthritis of right hip	Severe degenerative joint disease limiting ambulation and increasing need for powered mobility.
`M17.11`	Unilateral primary osteoarthritis of right knee	Degenerative knee disease causing gait instability and reduced endurance.
`G82.20`	Paraplegia, unspecified	Neurologic impairment often necessitating power mobility with higher weight capacity and specialized seating.
`I69.391`	Hemiplegia following cerebral infarction, right dominant side	Post-stroke weakness affecting ambulation—power wheelchair may be required for community mobility.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97542`	Wheelchair management (e.g., assessment, fitting, training)	Performed by occupational or physical therapists to assess seating, positioning, and train the patient on power wheelchair use prior to delivery.
`97001`	Physical therapy evaluation	Initial evaluation by a physical therapist to document mobility deficits supporting the need for powered mobility.
`99213`	Office or other outpatient visit for an established patient, moderate complexity	Used by the physician during the face-to-face evaluation documenting medical necessity for the power wheelchair prescription.
`99406`	Smoking and tobacco use cessation counseling visit, intermediate	Example of co-managed counseling services sometimes billed during clinic evaluation; not routinely linked but included when relevant to overall medical management.
`A9270`	Non-covered item or service (for DME tracking)	May be used for reporting non-covered accessories or features separate from the primary HCPCS; use per payer guidance.

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