Power Wheelchair, Group 4 Standard, Single Power Option

Name: Negotiated commercial rates for Power Wheelchair, Group 4 Standard, Single Power Option (HCPCS K0877), in Hawaii
Creator: Tynbil
License: https://tynbil.com/terms

Hawaii rates for HCPCS K0877

Power wheelchair, group 4 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds

Rates data updated July 2026.

Rates by insurance carrier

Insurance Carrier	Facility/Professional	Modifier	Typical Low	Median	Typical High