MyMedi-AI

A4637 — Replacement, tip, cane, crutch, walker, each.

HCPCS Level II A-code · short descriptor: “Repl tip cane/crutch/walker”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Special coverage instructions apply
DMEPOS payment category
Inexpensive or routinely purchased
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
4
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-16; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-16; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

A4637 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $2.20 to $3.18 depending on state and rural status.

StateNon-ruralRural
AK$3.02—
AL$2.20$2.22
AR$2.20$2.42
AZ$2.20$2.22
CA$2.20$2.42
CO$2.20$2.42
CT$2.20$2.42
DC$2.20$2.37
DE$2.20$2.31
FL$2.20$2.22
GA$2.20$2.22
HI$3.18—
IA$2.20$2.42
ID$2.20$2.22
IL$2.20$2.42
IN$2.20$2.37
KS$2.20$2.42
KY$2.20$2.42
LA$2.20$2.42
MA$2.20$2.42
MD$2.20$2.42
ME$2.20$2.42
MI$2.20$2.22
MN$2.20$2.22
MO$2.20$2.42
MS$2.20$2.42
MT$2.20$2.22
NC$2.20$2.42
ND$2.20$2.42
NE$2.20$2.42
NH$2.20$2.31
NJ$2.20$2.42
NM$2.20$2.22
NV$2.20$2.22
NY$2.20$2.22
OH$2.20$2.42
OK$2.20$2.22
OR$2.20$2.42
PA$2.20$2.42
PR$2.76—
RI$2.20$2.42
SC$2.20$2.42
SD$2.20$2.42
TN$2.20$2.22
TX$2.20$2.26
UT$2.20$2.22
VA$2.20$2.22
VI$2.22—
VT$2.20$2.31
WA$2.20$2.22
WI$2.20$2.42
WV$2.20$2.42
WY$2.20$2.33

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $2.38 to $3.48 depending on state and rural status.

StateNon-ruralRural
AK$3.30—
AL—$2.38
AR—$2.61
AZ—$2.38
CA—$2.61
CO—$2.61
CT—$2.61
DC—$2.55
DE—$2.49
FL—$2.38
GA—$2.38
HI$3.48—
IA—$2.61
ID—$2.38
IL—$2.61
IN—$2.55
KS—$2.61
KY—$2.61
LA—$2.61
MA—$2.61
MD—$2.61
ME—$2.61
MI—$2.38
MN—$2.38
MO—$2.61
MS—$2.61
MT—$2.38
NC—$2.61
ND—$2.61
NE—$2.61
NH—$2.49
NJ—$2.61
NM—$2.38
NV—$2.38
NY—$2.38
OH—$2.61
OK—$2.38
OR—$2.61
PA—$2.61
PR$3.01—
RI—$2.61
SC—$2.61
SD—$2.61
TN—$2.38
TX—$2.42
UT—$2.38
VA—$2.38
VI$2.38—
VT—$2.49
WA—$2.38
WI—$2.61
WV—$2.61
WY—$2.51

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $0.22 to $0.34 depending on state and rural status.

StateNon-ruralRural
AK$0.32—
AL$0.22$0.26
AR$0.22$0.29
AZ$0.22$0.29
CA$0.22$0.29
CO$0.22$0.26
CT$0.22$0.29
DC$0.22$0.26
DE$0.22$0.26
FL$0.22$0.26
GA$0.22$0.26
HI$0.34—
IA$0.22$0.29
ID$0.22$0.26
IL$0.22$0.29
IN$0.22$0.26
KS$0.22$0.29
KY$0.22$0.29
LA$0.22$0.29
MA$0.22$0.29
MD$0.22$0.29
ME$0.22$0.29
MI$0.22$0.26
MN$0.22$0.29
MO$0.22$0.29
MS$0.22$0.28
MT$0.22$0.26
NC$0.22$0.29
ND$0.22$0.29
NE$0.22$0.29
NH$0.22$0.26
NJ$0.22$0.29
NM$0.22$0.26
NV$0.22$0.29
NY$0.22$0.26
OH$0.22$0.29
OK$0.22$0.29
OR$0.22$0.29
PA$0.22$0.27
PR$0.32—
RI$0.22$0.29
SC$0.22$0.26
SD$0.22$0.29
TN$0.22$0.26
TX$0.22$0.27
UT$0.22$0.26
VA$0.22$0.26
VI$0.26—
VT$0.22$0.26
WA$0.22$0.26
WI$0.22$0.29
WV$0.22$0.29
WY$0.22$0.28

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $0.29 to $0.37 depending on state and rural status.

StateNon-ruralRural
AK$0.35—
AL—$0.29
AR—$0.32
AZ—$0.32
CA—$0.32
CO—$0.29
CT—$0.32
DC—$0.29
DE—$0.29
FL—$0.29
GA—$0.29
HI$0.37—
IA—$0.32
ID—$0.29
IL—$0.32
IN—$0.29
KS—$0.32
KY—$0.32
LA—$0.32
MA—$0.32
MD—$0.32
ME—$0.32
MI—$0.29
MN—$0.32
MO—$0.32
MS—$0.31
MT—$0.29
NC—$0.32
ND—$0.32
NE—$0.32
NH—$0.29
NJ—$0.32
NM—$0.29
NV—$0.32
NY—$0.29
OH—$0.32
OK—$0.32
OR—$0.32
PA—$0.29
PR$0.35—
RI—$0.32
SC—$0.29
SD—$0.32
TN—$0.29
TX—$0.29
UT—$0.29
VA—$0.29
VI$0.29—
VT—$0.29
WA—$0.29
WI—$0.32
WV—$0.32
WY—$0.30

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $1.66 to $2.37 depending on state and rural status.

StateNon-ruralRural
AK$2.28—
AL$1.66$1.68
AR$1.66$1.82
AZ$1.66$1.68
CA$1.66$1.82
CO$1.66$1.82
CT$1.66$1.82
DC$1.66$1.73
DE$1.66$1.74
FL$1.66$1.68
GA$1.66$1.68
HI$2.37—
IA$1.66$1.82
ID$1.66$1.68
IL$1.66$1.82
IN$1.66$1.76
KS$1.66$1.82
KY$1.66$1.82
LA$1.66$1.82
MA$1.66$1.82
MD$1.66$1.82
ME$1.66$1.82
MI$1.66$1.68
MN$1.66$1.68
MO$1.66$1.82
MS$1.66$1.82
MT$1.66$1.68
NC$1.66$1.82
ND$1.66$1.82
NE$1.66$1.82
NH$1.66$1.74
NJ$1.66$1.82
NM$1.66$1.68
NV$1.66$1.68
NY$1.66$1.70
OH$1.66$1.82
OK$1.66$1.82
OR$1.66$1.82
PA$1.66$1.72
PR$2.06—
RI$1.66$1.82
SC$1.66$1.82
SD$1.66$1.82
TN$1.66$1.68
TX$1.66$1.70
UT$1.66$1.68
VA$1.66$1.68
VI$1.70—
VT$1.66$1.74
WA$1.66$1.68
WI$1.66$1.82
WV$1.66$1.82
WY$1.66$1.75

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $1.80 to $2.60 depending on state and rural status.

StateNon-ruralRural
AK$2.49—
AL—$1.80
AR—$1.97
AZ—$1.80
CA—$1.97
CO—$1.97
CT—$1.97
DC—$1.86
DE—$1.87
FL—$1.80
GA—$1.80
HI$2.60—
IA—$1.97
ID—$1.80
IL—$1.97
IN—$1.90
KS—$1.97
KY—$1.97
LA—$1.97
MA—$1.97
MD—$1.97
ME—$1.97
MI—$1.80
MN—$1.80
MO—$1.97
MS—$1.97
MT—$1.80
NC—$1.97
ND—$1.97
NE—$1.97
NH—$1.87
NJ—$1.97
NM—$1.80
NV—$1.80
NY—$1.83
OH—$1.97
OK—$1.97
OR—$1.97
PA—$1.85
PR$2.24—
RI—$1.97
SC—$1.97
SD—$1.97
TN—$1.80
TX—$1.83
UT—$1.80
VA—$1.80
VI$1.83—
VT—$1.87
WA—$1.80
WI—$1.97
WV—$1.97
WY—$1.88
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps A4637 at 4 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

CO-50 medical necessityCO-151 frequency/units

Related A-codes

A4600A4601A4602A4604A4605A4606A4608A4611A4612A4613A4614A4615

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