E0957 — Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each
HCPCS Level II E-code · short descriptor: “W/c medial thigh support”
- Code system
- HCPCS Level II
- Family
- E — Durable medical equipment
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- 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
- 2
- 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.
E0957 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $139.65 to $185.53 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $168.59 | — |
| AL | $148.11 | $165.62 |
| AR | $148.11 | $165.62 |
| AZ | $150.34 | $165.62 |
| CA | $143.18 | $165.62 |
| CO | $153.17 | $165.62 |
| CT | $147.18 | $165.62 |
| DC | $139.65 | $165.62 |
| DE | $139.65 | $165.62 |
| FL | $148.11 | $165.62 |
| GA | $148.11 | $165.62 |
| HI | $168.59 | — |
| IA | $146.85 | $165.62 |
| ID | $153.17 | $165.62 |
| IL | $148.29 | $165.62 |
| IN | $148.29 | $165.62 |
| KS | $146.85 | $165.62 |
| KY | $148.11 | $165.62 |
| LA | $148.11 | $165.62 |
| MA | $147.18 | $165.62 |
| MD | $139.65 | $165.62 |
| ME | $147.18 | $165.62 |
| MI | $148.29 | $165.62 |
| MN | $146.85 | $165.62 |
| MO | $146.85 | $165.62 |
| MS | $148.11 | $165.62 |
| MT | $153.17 | $165.62 |
| NC | $148.11 | $165.62 |
| ND | $146.85 | $165.62 |
| NE | $146.85 | $165.62 |
| NH | $147.18 | $165.62 |
| NJ | $139.65 | $165.62 |
| NM | $150.34 | $165.62 |
| NV | $143.18 | $165.62 |
| NY | $139.65 | $165.62 |
| OH | $148.29 | $165.62 |
| OK | $150.34 | $165.62 |
| OR | $143.18 | $165.62 |
| PA | $139.65 | $165.62 |
| PR | $185.53 | — |
| RI | $147.18 | $165.62 |
| SC | $148.11 | $165.62 |
| SD | $146.85 | $165.62 |
| TN | $148.11 | $165.62 |
| TX | $150.34 | $165.62 |
| UT | $153.17 | $165.62 |
| VA | $148.11 | $165.62 |
| VI | $168.59 | — |
| VT | $147.18 | $165.62 |
| WA | $143.18 | $165.62 |
| WI | $148.29 | $165.62 |
| WV | $148.11 | $165.62 |
| WY | $153.17 | $165.62 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $177.90 to $200.27 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $180.88 | — |
| AL | — | $177.90 |
| AR | — | $177.90 |
| AZ | — | $177.90 |
| CA | — | $177.90 |
| CO | — | $177.90 |
| CT | — | $177.90 |
| DC | — | $177.90 |
| DE | — | $177.90 |
| FL | — | $177.90 |
| GA | — | $177.90 |
| HI | $180.88 | — |
| IA | — | $177.90 |
| ID | — | $177.90 |
| IL | — | $177.90 |
| IN | — | $177.90 |
| KS | — | $177.90 |
| KY | — | $177.90 |
| LA | — | $177.90 |
| MA | — | $177.90 |
| MD | — | $177.90 |
| ME | — | $177.90 |
| MI | — | $177.90 |
| MN | — | $177.90 |
| MO | — | $177.90 |
| MS | — | $177.90 |
| MT | — | $177.90 |
| NC | — | $177.90 |
| ND | — | $177.90 |
| NE | — | $177.90 |
| NH | — | $177.90 |
| NJ | — | $177.90 |
| NM | — | $177.90 |
| NV | — | $177.90 |
| NY | — | $177.90 |
| OH | — | $177.90 |
| OK | — | $177.90 |
| OR | — | $177.90 |
| PA | — | $177.90 |
| PR | $200.27 | — |
| RI | — | $177.90 |
| SC | — | $177.90 |
| SD | — | $177.90 |
| TN | — | $177.90 |
| TX | — | $177.90 |
| UT | — | $177.90 |
| VA | — | $177.90 |
| VI | $180.88 | — |
| VT | — | $177.90 |
| WA | — | $177.90 |
| WI | — | $177.90 |
| WV | — | $177.90 |
| WY | — | $177.90 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $169.44 to $203.31 depending on state and rural status.
Former-CBA payment limits: ceiling $169.44 · floor $144.02
| State | Non-rural | Rural |
|---|---|---|
| AK | $169.44 | — |
| AL | $169.44 | — |
| AR | $169.44 | — |
| AZ | $169.44 | — |
| CA | $169.44 | — |
| CO | $169.44 | — |
| CT | $169.44 | — |
| DC | $169.44 | — |
| DE | $169.44 | — |
| FL | $169.44 | — |
| GA | $169.44 | — |
| HI | $169.44 | — |
| IA | $169.44 | — |
| ID | $169.44 | — |
| IL | $169.44 | — |
| IN | $169.44 | — |
| KS | $169.44 | — |
| KY | $169.44 | — |
| LA | $169.44 | — |
| MA | $169.44 | — |
| MD | $169.44 | — |
| ME | $169.44 | — |
| MI | $169.44 | — |
| MN | $169.44 | — |
| MO | $169.44 | — |
| MS | $169.44 | — |
| MT | $169.44 | — |
| NC | $169.44 | — |
| ND | $169.44 | — |
| NE | $169.44 | — |
| NH | $169.44 | — |
| NJ | $169.44 | — |
| NM | $169.44 | — |
| NV | $169.44 | — |
| NY | $169.44 | — |
| OH | $169.44 | — |
| OK | $169.44 | — |
| OR | $169.44 | — |
| PA | $169.44 | — |
| PR | $203.31 | — |
| RI | $169.44 | — |
| SC | $169.44 | — |
| SD | $169.44 | — |
| TN | $169.44 | — |
| TX | $169.44 | — |
| UT | $169.44 | — |
| VA | $169.44 | — |
| VI | $169.44 | — |
| VT | $169.44 | — |
| WA | $169.44 | — |
| WI | $169.44 | — |
| WV | $169.44 | — |
| WY | $169.44 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $13.96 to $18.54 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $16.86 | — |
| AL | $14.81 | $16.56 |
| AR | $14.81 | $16.56 |
| AZ | $15.04 | $16.56 |
| CA | $14.32 | $16.56 |
| CO | $15.32 | $16.56 |
| CT | $14.72 | $16.56 |
| DC | $13.96 | $16.56 |
| DE | $13.96 | $16.56 |
| FL | $14.81 | $16.56 |
| GA | $14.81 | $16.56 |
| HI | $16.86 | — |
| IA | $14.69 | $16.56 |
| ID | $15.32 | $16.56 |
| IL | $14.83 | $16.56 |
| IN | $14.83 | $16.56 |
| KS | $14.69 | $16.56 |
| KY | $14.81 | $16.56 |
| LA | $14.81 | $16.56 |
| MA | $14.72 | $16.56 |
| MD | $13.96 | $16.56 |
| ME | $14.72 | $16.56 |
| MI | $14.83 | $16.56 |
| MN | $14.69 | $16.56 |
| MO | $14.69 | $16.56 |
| MS | $14.81 | $16.56 |
| MT | $15.32 | $16.56 |
| NC | $14.81 | $16.56 |
| ND | $14.69 | $16.56 |
| NE | $14.69 | $16.56 |
| NH | $14.72 | $16.56 |
| NJ | $13.96 | $16.56 |
| NM | $15.04 | $16.56 |
| NV | $14.32 | $16.56 |
| NY | $13.96 | $16.56 |
| OH | $14.83 | $16.56 |
| OK | $15.04 | $16.56 |
| OR | $14.32 | $16.56 |
| PA | $13.96 | $16.56 |
| PR | $18.54 | — |
| RI | $14.72 | $16.56 |
| SC | $14.81 | $16.56 |
| SD | $14.69 | $16.56 |
| TN | $14.81 | $16.56 |
| TX | $15.04 | $16.56 |
| UT | $15.32 | $16.56 |
| VA | $14.81 | $16.56 |
| VI | $16.86 | — |
| VT | $14.72 | $16.56 |
| WA | $14.32 | $16.56 |
| WI | $14.83 | $16.56 |
| WV | $14.81 | $16.56 |
| WY | $15.32 | $16.56 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $17.79 to $20.02 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $18.09 | — |
| AL | — | $17.79 |
| AR | — | $17.79 |
| AZ | — | $17.79 |
| CA | — | $17.79 |
| CO | — | $17.79 |
| CT | — | $17.79 |
| DC | — | $17.79 |
| DE | — | $17.79 |
| FL | — | $17.79 |
| GA | — | $17.79 |
| HI | $18.09 | — |
| IA | — | $17.79 |
| ID | — | $17.79 |
| IL | — | $17.79 |
| IN | — | $17.79 |
| KS | — | $17.79 |
| KY | — | $17.79 |
| LA | — | $17.79 |
| MA | — | $17.79 |
| MD | — | $17.79 |
| ME | — | $17.79 |
| MI | — | $17.79 |
| MN | — | $17.79 |
| MO | — | $17.79 |
| MS | — | $17.79 |
| MT | — | $17.79 |
| NC | — | $17.79 |
| ND | — | $17.79 |
| NE | — | $17.79 |
| NH | — | $17.79 |
| NJ | — | $17.79 |
| NM | — | $17.79 |
| NV | — | $17.79 |
| NY | — | $17.79 |
| OH | — | $17.79 |
| OK | — | $17.79 |
| OR | — | $17.79 |
| PA | — | $17.79 |
| PR | $20.02 | — |
| RI | — | $17.79 |
| SC | — | $17.79 |
| SD | — | $17.79 |
| TN | — | $17.79 |
| TX | — | $17.79 |
| UT | — | $17.79 |
| VA | — | $17.79 |
| VI | $18.09 | — |
| VT | — | $17.79 |
| WA | — | $17.79 |
| WI | — | $17.79 |
| WV | — | $17.79 |
| WY | — | $17.79 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $16.96 to $20.32 depending on state and rural status.
Former-CBA payment limits: ceiling $16.96 · floor $14.42
| State | Non-rural | Rural |
|---|---|---|
| AK | $16.96 | — |
| AL | $16.96 | — |
| AR | $16.96 | — |
| AZ | $16.96 | — |
| CA | $16.96 | — |
| CO | $16.96 | — |
| CT | $16.96 | — |
| DC | $16.96 | — |
| DE | $16.96 | — |
| FL | $16.96 | — |
| GA | $16.96 | — |
| HI | $16.96 | — |
| IA | $16.96 | — |
| ID | $16.96 | — |
| IL | $16.96 | — |
| IN | $16.96 | — |
| KS | $16.96 | — |
| KY | $16.96 | — |
| LA | $16.96 | — |
| MA | $16.96 | — |
| MD | $16.96 | — |
| ME | $16.96 | — |
| MI | $16.96 | — |
| MN | $16.96 | — |
| MO | $16.96 | — |
| MS | $16.96 | — |
| MT | $16.96 | — |
| NC | $16.96 | — |
| ND | $16.96 | — |
| NE | $16.96 | — |
| NH | $16.96 | — |
| NJ | $16.96 | — |
| NM | $16.96 | — |
| NV | $16.96 | — |
| NY | $16.96 | — |
| OH | $16.96 | — |
| OK | $16.96 | — |
| OR | $16.96 | — |
| PA | $16.96 | — |
| PR | $20.32 | — |
| RI | $16.96 | — |
| SC | $16.96 | — |
| SD | $16.96 | — |
| TN | $16.96 | — |
| TX | $16.96 | — |
| UT | $16.96 | — |
| VA | $16.96 | — |
| VI | $16.96 | — |
| VT | $16.96 | — |
| WA | $16.96 | — |
| WI | $16.96 | — |
| WV | $16.96 | — |
| WY | $16.96 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $104.74 to $139.14 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $126.44 | — |
| AL | $111.09 | $124.22 |
| AR | $111.09 | $124.22 |
| AZ | $112.76 | $124.22 |
| CA | $107.39 | $124.22 |
| CO | $114.88 | $124.22 |
| CT | $110.39 | $124.22 |
| DC | $104.74 | $124.22 |
| DE | $104.74 | $124.22 |
| FL | $111.09 | $124.22 |
| GA | $111.09 | $124.22 |
| HI | $126.44 | — |
| IA | $110.14 | $124.22 |
| ID | $114.88 | $124.22 |
| IL | $111.22 | $124.22 |
| IN | $111.22 | $124.22 |
| KS | $110.14 | $124.22 |
| KY | $111.09 | $124.22 |
| LA | $111.09 | $124.22 |
| MA | $110.39 | $124.22 |
| MD | $104.74 | $124.22 |
| ME | $110.39 | $124.22 |
| MI | $111.22 | $124.22 |
| MN | $110.14 | $124.22 |
| MO | $110.14 | $124.22 |
| MS | $111.09 | $124.22 |
| MT | $114.88 | $124.22 |
| NC | $111.09 | $124.22 |
| ND | $110.14 | $124.22 |
| NE | $110.14 | $124.22 |
| NH | $110.39 | $124.22 |
| NJ | $104.74 | $124.22 |
| NM | $112.76 | $124.22 |
| NV | $107.39 | $124.22 |
| NY | $104.74 | $124.22 |
| OH | $111.22 | $124.22 |
| OK | $112.76 | $124.22 |
| OR | $107.39 | $124.22 |
| PA | $104.74 | $124.22 |
| PR | $139.14 | — |
| RI | $110.39 | $124.22 |
| SC | $111.09 | $124.22 |
| SD | $110.14 | $124.22 |
| TN | $111.09 | $124.22 |
| TX | $112.76 | $124.22 |
| UT | $114.88 | $124.22 |
| VA | $111.09 | $124.22 |
| VI | $126.44 | — |
| VT | $110.39 | $124.22 |
| WA | $107.39 | $124.22 |
| WI | $111.22 | $124.22 |
| WV | $111.09 | $124.22 |
| WY | $114.88 | $124.22 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $133.43 to $150.19 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $135.66 | — |
| AL | — | $133.43 |
| AR | — | $133.43 |
| AZ | — | $133.43 |
| CA | — | $133.43 |
| CO | — | $133.43 |
| CT | — | $133.43 |
| DC | — | $133.43 |
| DE | — | $133.43 |
| FL | — | $133.43 |
| GA | — | $133.43 |
| HI | $135.66 | — |
| IA | — | $133.43 |
| ID | — | $133.43 |
| IL | — | $133.43 |
| IN | — | $133.43 |
| KS | — | $133.43 |
| KY | — | $133.43 |
| LA | — | $133.43 |
| MA | — | $133.43 |
| MD | — | $133.43 |
| ME | — | $133.43 |
| MI | — | $133.43 |
| MN | — | $133.43 |
| MO | — | $133.43 |
| MS | — | $133.43 |
| MT | — | $133.43 |
| NC | — | $133.43 |
| ND | — | $133.43 |
| NE | — | $133.43 |
| NH | — | $133.43 |
| NJ | — | $133.43 |
| NM | — | $133.43 |
| NV | — | $133.43 |
| NY | — | $133.43 |
| OH | — | $133.43 |
| OK | — | $133.43 |
| OR | — | $133.43 |
| PA | — | $133.43 |
| PR | $150.19 | — |
| RI | — | $133.43 |
| SC | — | $133.43 |
| SD | — | $133.43 |
| TN | — | $133.43 |
| TX | — | $133.43 |
| UT | — | $133.43 |
| VA | — | $133.43 |
| VI | $135.66 | — |
| VT | — | $133.43 |
| WA | — | $133.43 |
| WI | — | $133.43 |
| WV | — | $133.43 |
| WY | — | $133.43 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $127.06 to $152.47 depending on state and rural status.
Former-CBA payment limits: ceiling $127.06 · floor $108.00
| State | Non-rural | Rural |
|---|---|---|
| AK | $127.06 | — |
| AL | $127.06 | — |
| AR | $127.06 | — |
| AZ | $127.06 | — |
| CA | $127.06 | — |
| CO | $127.06 | — |
| CT | $127.06 | — |
| DC | $127.06 | — |
| DE | $127.06 | — |
| FL | $127.06 | — |
| GA | $127.06 | — |
| HI | $127.06 | — |
| IA | $127.06 | — |
| ID | $127.06 | — |
| IL | $127.06 | — |
| IN | $127.06 | — |
| KS | $127.06 | — |
| KY | $127.06 | — |
| LA | $127.06 | — |
| MA | $127.06 | — |
| MD | $127.06 | — |
| ME | $127.06 | — |
| MI | $127.06 | — |
| MN | $127.06 | — |
| MO | $127.06 | — |
| MS | $127.06 | — |
| MT | $127.06 | — |
| NC | $127.06 | — |
| ND | $127.06 | — |
| NE | $127.06 | — |
| NH | $127.06 | — |
| NJ | $127.06 | — |
| NM | $127.06 | — |
| NV | $127.06 | — |
| NY | $127.06 | — |
| OH | $127.06 | — |
| OK | $127.06 | — |
| OR | $127.06 | — |
| PA | $127.06 | — |
| PR | $152.47 | — |
| RI | $127.06 | — |
| SC | $127.06 | — |
| SD | $127.06 | — |
| TN | $127.06 | — |
| TX | $127.06 | — |
| UT | $127.06 | — |
| VA | $127.06 | — |
| VI | $127.06 | — |
| VT | $127.06 | — |
| WA | $127.06 | — |
| WI | $127.06 | — |
| WV | $127.06 | — |
| WY | $127.06 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0957 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.
Common denial codes to watch
Related E-codes
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