The HCPCS CODES provided are based on code verification through PDAC or our interpretation of the code definitions.
The use of HCPCS CODES does not ensure coverage or payment. For coverage information, verify the appropriate payer's coverage policy.
Price
DefinitionHCPCSOption #Option # HCPCS
Price
Definition
1. QUICKIE S636 BC/SC/MPC POWER CHAIR
NC
105C108
Zebra (Choose base color above:
White Std, n/a black)
NC105C148 Mauve Pink NC
Mossy Oak Camouflage
NC
105C126
105C42 Stars and Stripes
NC
105C147 Hot Sparkle Pink
105C144 Green Apple
NC
105C43
Glow
NC
105C149 Matte Evergreen
Custom Colors
NC
105C143 Evergreen
NC
105C150
Candy Red
NC
Matte Electric Blue
NC
105C142 Electric Blue
NC
NC
105C14 Candy Purple
NC
105C152 Matte Purple
NC
105C35
Candy Blue
NC
105C151 Matte Black Cherry
105C38 Blue Opal
NC
Standard Matte Colors
105C105 Matte Black
NC
105C36
Titanium Color Paint
NC
105C10 Black Opal
NC
105C8 Yellow
NC
105C141 Black Cherry
NC
105C113
105C145 Sunrise Orange
NC
NC
105C140 Aztec Gold
NC
105C114 Sparkle Silver
NC
2. FRAME COLOR OPTIONS
14"
Seat Width
17"
18" N/C
Rootbeer
Seat Height
Seat Rail Type
105C103
19" (Not available with power seating
options.
N/C
20" (Add .5" for Power CG Tilt or Tilt
and Recline.)
Standard Colors
105C2 Black
(Not avail as base w/Zebra)
NC
16" N/C
N/C
N/C
15" N/C
105FT47
N/C
105HT12
N/C
105HT10
105HT17
N/C18" (Add .5" for Power CG Tilt or Tilt
and Recline.)
20"
N/C
N/C
105FA3
14"
15"
N/C
N/C
105FT50
105FA4
19"
105SD12
22" N/C
21"
105SD7
22" Wide base (27-3/4") Included.
N/C
105SD13
105SD9
105SD10
20"
105W14
105W13
105SD14
105W9
105SD33
Seat Depth
105SD8
N/C
N/C
N/C
105W10
105FA5
N/C
17"
N/C
105W11
19"
105W8
105HT14
18"
105SD11
24" Wide base (27-3/4") Included.
105W7
105W6
16"
N/C
N/C
21" (Not available with power seating
options.
105W5
N/C
N/C
Seat Frame Angle
3°
6°
Not avail. w/ 18" seat height.
9°
Not avail. w/ 18" seat height.
N/C
Straight Seat Frame (not avail. With
power ALR/ELR)
N/C
Flared Seat Frame (Add 1" ea.side) N/C
ORDERING INFORMATION: PHONE: (800) 333-4000 FAX: (800) 300-7502 WEBSITE: www.sunrisemedical.com
Specifications are subject to change without notice. Copyright © 2014
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