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Billing code E0277 · Equipment & supplies

E0277 Medicaid reimbursement rate by state (2026)

Powered pressure-reducing air mattress. Medicaid pays a median of $349.15 for E0277 across 44 states, from $5.56 in Wisconsin to $5,131.21 in North Carolina.

Data as of Oct 5, 202644 statesEvery rate links to its official source

States publishing
44
National median
$349.15units vary by state
Lowest
$5.56Wisconsin
Highest
$5,131.21North Carolina
Answer

What does Medicaid pay for E0277?

44 state Medicaid programs publish a fee-for-service rate for E0277. The national median is $349.15 (units differ between states). North Carolina pays the most, $5,131.21, and Wisconsin the least, $5.56, a 922.9x spread.

State ranking

E0277 rate by state: highest, middle and lowest

One like-for-like fee-for-service rate per state, ranked. The workspace lists all 44 states with every variant, modifier and effective date.

#StateMedicaid rateUnitPer hourManaged-care plans% of Medicare
1North Carolina Source · since 2025-10-01$5,131.21——Plans negotiate; applies out of network—
2Vermont Source · since 2026-01-01$4,952.24——Not classified—
3Idaho Source · since 2026-07-01$4,869.16——Not classified—
22New York Source · since 2022-06-01$400.14——Plans negotiate; applies out of network—
23Illinois Source · since 2019-07-24$298.15——Plans negotiate; applies out of network—
24North Dakota Source · since 2026-02-08$257.64——Not classified—
43Utah Source · since 2026-07-01$5.96——Plans negotiate; applies out of network—
44Wisconsin Source · since 2026-01-01$5.56——Plans negotiate; applies out of network—
See all 44 states for E0277 — start free

36 more states, with every modifier and provider-type variant, rate history and the plan rule in each state. 14-day free trial, no credit card.

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Rates are per the unit shown for each state; units can differ between states. Medicare amounts are computed from the CMS relative value file and locality cost indices; states with several Medicare localities show a range. Confirm rates with the payer before billing.

Track E0277 in your states. Get an alert when any state changes it, with every variant and the managed-care rule.
Guide

How to read this table

  • Order. States are listed from the highest published rate to the lowest. No single unit is shared by 8 or more states for E0277, so the order is by published amount and is not a like-for-like rank.
  • Medicaid rate. The most the state's fee-for-service program pays for one unit, as published. 31 of the 44 states list more than one rate for E0277, by modifier, provider type or setting; the table shows the one that matches the provider level and setting used across states, without add-ons.
  • Unit. Of the 44 states, 3 publish E0277 per unit and 1 per new purchase, and 40 schedules print no unit at all (a flat amount per service).
  • Per hour. E0277 is not billed in time units in these states, so no hourly figure is shown.
  • Managed-care plans. The rule the state sets for its plans on this rate. What each rule means is explained below.
  • % of Medicare. No Medicare physician fee schedule amount is on file for E0277, so there is no percentage.
  • Source and date. Each Source link opens the state's own document; “since” is the date the rate took effect.
Context

Why E0277 rates differ between states

Published rates for E0277 run from $5.56 in Wisconsin to $5,131.21 in North Carolina, a 922.9x gap in the same unit. Half the states pay more than the median of $349.15 and half pay less. The usual reasons for a spread like this in equipment & supplies rates:

  • Some items are priced individually from the manufacturer's price or the supplier's invoice, so fewer states publish a fixed fee.
  • Many states set equipment and supply fees as a percentage of the Medicare DMEPOS fee schedule, at different percentages and from different years.
  • A single code can carry separate purchase, rental and used-equipment amounts, and states publish different subsets of them.

Timing matters too. 28 states set the current rate for E0277 in 2026 or later, while 11 states still pay a rate that took effect in 2022 or earlier. A state that has not updated its rate in years will drift down the ranking as others raise theirs.

Managed care

What managed-care plans pay for E0277

What a plan pays for E0277 is negotiated privately, but the state decides how much room there is to negotiate. Here is how the rules break down across the 44 states.

In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 17 states is not classified yet.

  • Plans negotiate; the published rate applies out of network (18 states). In-network rates can be above or below the published rate. The published rate is the benchmark both sides know, and the fallback if no contract is signed.
  • Plans must pay at least the published rate (7 states). The published rate is your floor. Negotiate up from it, and if a plan pays less, the contract provision is the basis for a payment dispute.
  • The state sets the plan rate (2 states). There is little to negotiate on price. Contracting is about network participation, authorization and billing terms.

Plan-negotiated rates are never estimated here. To see the rule and its citation for a particular state, open that state's managed-care page, for example North Carolina managed care.

Billing

Units and billing for E0277

E0277 is a HCPCS Level II durable medical equipment code in the equipment & supplies line, billed mostly by durable medical equipment suppliers, orthotists, prosthetists and pharmacies. E codes cover durable medical equipment. The same code can carry a purchase price, a monthly rental and a used-equipment price, chosen with a pricing modifier.

Units follow the code: per item, per pair, per box or per month of rental, so a per-unit comparison only holds when the states use the same unit. Pricing modifiers decide which amount applies: NU for a new purchase, RR for a monthly rental and UE for used equipment.

Before billing, confirm the rate, unit and any modifier with the state's current schedule or the plan: the amounts here are as published, not a guarantee of payment.

FAQ

Frequently asked questions

What does Medicaid pay for E0277?

It depends on the state. Of the 44 states with a published fee-for-service rate, the median is $349.15. North Carolina pays the most ($5,131.21) and Wisconsin the least ($5.56).

Which state pays the highest Medicaid rate for E0277?

North Carolina, at $5,131.21, effective 2025-10-01.

Which state pays the lowest Medicaid rate for E0277?

Wisconsin, at $5.56, effective 2026-01-01.

What unit is E0277 billed in?

Of the 44 states, 3 publish E0277 per unit and 1 per new purchase, and 40 schedules print no unit at all (a flat amount per service).

Do managed-care plans pay the same rate for E0277?

Not necessarily. In 9 states, the published rate binds plans: a floor, a pass-through or a state-set rate. In 18 states, plans negotiate and the published rate is a benchmark or out-of-network default. The rule for the remaining 17 states is not classified yet. Each rule is cited to the plan contract, statute or notice in the workspace.