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CGS Administrators, LLC

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Power Mobility Devices Weight Requirements Tool

This tool helps suppliers choose the appropriate power mobility base as determined by the beneficiary’s weight. The Power Mobility Devices LCD (L33789) allows for a supplier to provide the next classification of base if the beneficiary’s weight is within 5% of the maximum weight capacity per the HCPCS code description.

For example, a K0823 has a weight capacity up to and including 300 pounds.  If the beneficiary’s weight is 294 pounds, they are within 5% of the maximum (285 pounds or more) and the supplier could provide a K0825 wheelchair base, which has a capacity of 301 to 450 pounds.

Search by HCPCS code:

Enter a power mobility device base HCPCS code then click “Check”. The result will be the beneficiary weight range for that HCPCS code.

Search by Weight:

Enter a weight (value only – for a beneficiary weighing 229 pounds, type in “229”) then click “Check”. The result will be a range of HCPCS codes that are applicable for that weight.

Note: The presence of a HCPCS code on this tool has no bearing on coverage or required documentation. Suppliers should review the “Coverage Indications, Limitations and/or Medical Necessity” section of the Power Mobility Devices LCD (L33789) for reasonable and necessary guidelines.

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