| K0861 | Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds | 170 | $1,370 | $238.4K |
| E1008 | Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction | 210 | $710 | $147.8K |
| E2311 | Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function… | 360 | $170 | $62.6K |
| E1012 | Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each | 390 | $70 | $26K |
| E2313 | Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each | 360 | $70 | $24.3K |
| E2377 | Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue | 350 | $50 | $16.8K |
| E1028 | Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other | 1,310 | $10 | $13.1K |
| K0823 | Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds | 530 | $20 | $10.6K |
| E1007 | Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction | 20 | $470 | $9.5K |
| K0739 | Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes | 320 | $20 | $7.2K |