E0667 — Segmental pneumatic appliance for use with pneumatic compressor, full leg
HCPCS Level II E-code · short descriptor: “Seg pneumatic appl full leg”
- 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
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
E0667 Medicare fee schedule (April 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $392.20 to $1054.26 depending on state and rural status.
Former-CBA payment limits: ceiling $461.41 · floor $392.20
| State | Non-rural | Rural |
|---|---|---|
| AK | $985.95 | — |
| AL | $461.41 | — |
| AR | $461.41 | — |
| AZ | $461.41 | — |
| CA | $461.41 | — |
| CO | $392.20 | — |
| CT | $461.41 | — |
| DC | $461.41 | — |
| DE | $461.41 | — |
| FL | $461.41 | — |
| GA | $461.41 | — |
| HI | $1054.26 | — |
| IA | $392.20 | — |
| ID | $461.41 | — |
| IL | $461.41 | — |
| IN | $392.20 | — |
| KS | $392.20 | — |
| KY | $461.41 | — |
| LA | $461.41 | — |
| MA | $392.20 | — |
| MD | $461.41 | — |
| ME | $392.20 | — |
| MI | $461.41 | — |
| MN | $392.20 | — |
| MO | $392.20 | — |
| MS | $392.20 | — |
| MT | $392.20 | — |
| NC | $461.41 | — |
| ND | $392.20 | — |
| NE | $392.20 | — |
| NH | $392.20 | — |
| NJ | $461.41 | — |
| NM | $461.41 | — |
| NV | $461.41 | — |
| NY | $461.41 | — |
| OH | $461.39 | — |
| OK | $441.03 | — |
| OR | $461.41 | — |
| PA | $461.41 | — |
| PR | $621.48 | — |
| RI | $461.41 | — |
| SC | $461.41 | — |
| SD | $392.20 | — |
| TN | $461.41 | — |
| TX | $461.41 | — |
| UT | $444.17 | — |
| VA | $392.20 | — |
| VI | $461.41 | — |
| VT | $392.20 | — |
| WA | $461.41 | — |
| WI | $461.41 | — |
| WV | $461.39 | — |
| WY | $392.20 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $44.29 to $105.41 depending on state and rural status.
Former-CBA payment limits: ceiling $52.10 · floor $44.29
| State | Non-rural | Rural |
|---|---|---|
| AK | $98.58 | — |
| AL | $52.10 | — |
| AR | $52.10 | — |
| AZ | $52.10 | — |
| CA | $52.10 | — |
| CO | $44.29 | — |
| CT | $52.10 | — |
| DC | $46.18 | — |
| DE | $46.18 | — |
| FL | $52.10 | — |
| GA | $52.10 | — |
| HI | $105.41 | — |
| IA | $44.29 | — |
| ID | $52.10 | — |
| IL | $52.10 | — |
| IN | $44.29 | — |
| KS | $44.29 | — |
| KY | $52.10 | — |
| LA | $52.10 | — |
| MA | $52.10 | — |
| MD | $46.18 | — |
| ME | $52.10 | — |
| MI | $52.10 | — |
| MN | $44.29 | — |
| MO | $44.29 | — |
| MS | $44.29 | — |
| MT | $44.29 | — |
| NC | $52.10 | — |
| ND | $44.29 | — |
| NE | $44.29 | — |
| NH | $52.10 | — |
| NJ | $46.18 | — |
| NM | $48.35 | — |
| NV | $52.10 | — |
| NY | $52.10 | — |
| OH | $46.18 | — |
| OK | $44.29 | — |
| OR | $52.10 | — |
| PA | $46.18 | — |
| PR | $77.67 | — |
| RI | $52.10 | — |
| SC | $52.10 | — |
| SD | $44.29 | — |
| TN | $52.10 | — |
| TX | $52.10 | — |
| UT | $44.44 | — |
| VA | $44.29 | — |
| VI | $52.10 | — |
| VT | $52.10 | — |
| WA | $52.10 | — |
| WI | $52.10 | — |
| WV | $46.18 | — |
| WY | $44.29 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $294.17 to $790.68 depending on state and rural status.
Former-CBA payment limits: ceiling $346.08 · floor $294.17
| State | Non-rural | Rural |
|---|---|---|
| AK | $739.45 | — |
| AL | $346.08 | — |
| AR | $346.08 | — |
| AZ | $346.08 | — |
| CA | $346.08 | — |
| CO | $294.17 | — |
| CT | $346.08 | — |
| DC | $346.07 | — |
| DE | $346.07 | — |
| FL | $346.08 | — |
| GA | $346.08 | — |
| HI | $790.68 | — |
| IA | $294.17 | — |
| ID | $346.08 | — |
| IL | $346.08 | — |
| IN | $294.17 | — |
| KS | $294.17 | — |
| KY | $346.08 | — |
| LA | $346.08 | — |
| MA | $294.17 | — |
| MD | $346.08 | — |
| ME | $294.17 | — |
| MI | $346.08 | — |
| MN | $294.17 | — |
| MO | $294.17 | — |
| MS | $294.17 | — |
| MT | $294.17 | — |
| NC | $346.08 | — |
| ND | $294.17 | — |
| NE | $294.17 | — |
| NH | $294.17 | — |
| NJ | $346.07 | — |
| NM | $346.08 | — |
| NV | $346.08 | — |
| NY | $346.08 | — |
| OH | $346.07 | — |
| OK | $330.75 | — |
| OR | $346.08 | — |
| PA | $346.08 | — |
| PR | $466.12 | — |
| RI | $346.08 | — |
| SC | $346.08 | — |
| SD | $294.17 | — |
| TN | $346.08 | — |
| TX | $346.08 | — |
| UT | $333.11 | — |
| VA | $294.17 | — |
| VI | $346.08 | — |
| VT | $294.17 | — |
| WA | $346.08 | — |
| WI | $346.08 | — |
| WV | $346.07 | — |
| WY | $294.17 | — |
Common denial codes to watch
Related E-codes
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