E0167 — Pail or pan for use with commode chair, replacement only
HCPCS Level II E-code · short descriptor: “Commode chair pail or pan”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- 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
- 1
- 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 2026-10-25; 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 2026-10-25; 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.
E0167 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $12.56 to $17.35 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $16.08 | — |
| AL | $12.63 | $14.53 |
| AR | $12.63 | $15.95 |
| AZ | $13.21 | $15.95 |
| CA | $13.06 | $15.95 |
| CO | $12.56 | $14.53 |
| CT | $14.80 | $15.95 |
| DC | $13.60 | $14.92 |
| DE | $13.60 | $14.92 |
| FL | $12.63 | $14.57 |
| GA | $12.63 | $14.53 |
| HI | $16.67 | — |
| IA | $13.22 | $15.95 |
| ID | $12.56 | $15.95 |
| IL | $14.45 | $15.95 |
| IN | $14.45 | $15.95 |
| KS | $13.22 | $15.95 |
| KY | $12.63 | $14.53 |
| LA | $12.63 | $14.53 |
| MA | $14.80 | $15.95 |
| MD | $13.60 | $14.53 |
| ME | $14.80 | $15.95 |
| MI | $14.45 | $15.95 |
| MN | $13.22 | $15.94 |
| MO | $13.22 | $15.95 |
| MS | $12.63 | $15.95 |
| MT | $12.56 | $15.42 |
| NC | $12.63 | $15.64 |
| ND | $13.22 | $14.53 |
| NE | $13.22 | $15.95 |
| NH | $14.53 | $14.53 |
| NJ | $13.60 | $15.95 |
| NM | $13.21 | $15.95 |
| NV | $13.06 | $15.95 |
| NY | $13.60 | $15.95 |
| OH | $14.45 | $15.95 |
| OK | $13.21 | $14.80 |
| OR | $13.06 | $15.87 |
| PA | $13.60 | $14.53 |
| PR | $17.35 | — |
| RI | $14.80 | $15.95 |
| SC | $12.63 | $15.54 |
| SD | $13.22 | $15.95 |
| TN | $12.63 | $15.85 |
| TX | $13.21 | $15.91 |
| UT | $12.56 | $15.95 |
| VA | $12.63 | $15.04 |
| VI | $15.95 | — |
| VT | $14.53 | $14.53 |
| WA | $13.06 | $15.95 |
| WI | $14.45 | $15.40 |
| WV | $12.63 | $15.95 |
| WY | $12.56 | $15.29 |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $1.26 to $1.98 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $1.60 | — |
| AL | $1.26 | $1.50 |
| AR | $1.26 | $1.63 |
| AZ | $1.32 | $1.63 |
| CA | $1.31 | $1.59 |
| CO | $1.26 | $1.63 |
| CT | $1.48 | $1.63 |
| DC | $1.36 | $1.63 |
| DE | $1.36 | $1.63 |
| FL | $1.26 | $1.50 |
| GA | $1.26 | $1.50 |
| HI | $1.67 | — |
| IA | $1.32 | $1.63 |
| ID | $1.26 | $1.63 |
| IL | $1.45 | $1.63 |
| IN | $1.45 | $1.61 |
| KS | $1.32 | $1.63 |
| KY | $1.26 | $1.50 |
| LA | $1.26 | $1.50 |
| MA | $1.48 | $1.50 |
| MD | $1.36 | $1.63 |
| ME | $1.48 | $1.50 |
| MI | $1.45 | $1.63 |
| MN | $1.32 | $1.59 |
| MO | $1.32 | $1.63 |
| MS | $1.26 | $1.59 |
| MT | $1.26 | $1.54 |
| NC | $1.26 | $1.56 |
| ND | $1.32 | $1.50 |
| NE | $1.32 | $1.63 |
| NH | $1.48 | $1.63 |
| NJ | $1.36 | $1.63 |
| NM | $1.32 | $1.63 |
| NV | $1.31 | $1.63 |
| NY | $1.36 | $1.62 |
| OH | $1.45 | $1.61 |
| OK | $1.32 | $1.50 |
| OR | $1.31 | $1.59 |
| PA | $1.36 | $1.63 |
| PR | $1.98 | — |
| RI | $1.48 | $1.63 |
| SC | $1.26 | $1.50 |
| SD | $1.32 | $1.63 |
| TN | $1.26 | $1.58 |
| TX | $1.32 | $1.59 |
| UT | $1.26 | $1.63 |
| VA | $1.26 | $1.63 |
| VI | $1.62 | — |
| VT | $1.48 | $1.63 |
| WA | $1.31 | $1.59 |
| WI | $1.45 | $1.54 |
| WV | $1.26 | $1.63 |
| WY | $1.26 | $1.53 |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $9.42 to $13.00 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $12.06 | — |
| AL | $9.47 | $11.43 |
| AR | $9.47 | $12.00 |
| AZ | $9.91 | $12.00 |
| CA | $9.80 | $12.00 |
| CO | $9.42 | $10.95 |
| CT | $11.10 | $12.00 |
| DC | $10.20 | $11.21 |
| DE | $10.20 | $11.21 |
| FL | $9.47 | $10.95 |
| GA | $9.47 | $11.56 |
| HI | $12.51 | — |
| IA | $9.92 | $12.00 |
| ID | $9.42 | $12.00 |
| IL | $10.84 | $12.00 |
| IN | $10.84 | $12.00 |
| KS | $9.92 | $12.00 |
| KY | $9.47 | $10.95 |
| LA | $9.47 | $10.95 |
| MA | $11.10 | $12.00 |
| MD | $10.20 | $11.64 |
| ME | $11.10 | $12.00 |
| MI | $10.84 | $12.00 |
| MN | $9.92 | $11.98 |
| MO | $9.92 | $12.00 |
| MS | $9.47 | $11.98 |
| MT | $9.42 | $11.58 |
| NC | $9.47 | $11.72 |
| ND | $9.92 | $10.95 |
| NE | $9.92 | $12.00 |
| NH | $10.95 | $10.95 |
| NJ | $10.20 | $12.00 |
| NM | $9.91 | $12.00 |
| NV | $9.80 | $12.00 |
| NY | $10.20 | $12.00 |
| OH | $10.84 | $12.00 |
| OK | $9.91 | $11.08 |
| OR | $9.80 | $11.91 |
| PA | $10.20 | $11.84 |
| PR | $13.00 | — |
| RI | $11.10 | $12.00 |
| SC | $9.47 | $11.64 |
| SD | $9.92 | $12.00 |
| TN | $9.47 | $11.90 |
| TX | $9.91 | $12.00 |
| UT | $9.42 | $12.00 |
| VA | $9.47 | $11.28 |
| VI | $12.00 | — |
| VT | $10.95 | $10.95 |
| WA | $9.80 | $12.00 |
| WI | $10.84 | $11.56 |
| WV | $9.47 | $12.00 |
| WY | $9.42 | $11.47 |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0167 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.
Common denial codes to watch
Related E-codes
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