E0959 — Manual wheelchair accessory, adapter for amputee, each
HCPCS Level II E-code · short descriptor: “Amputee adapter”
- 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.
E0959 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $52.33 to $84.74 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $84.74 | — |
| AL | $52.91 | $53.55 |
| AR | $52.91 | $61.28 |
| AZ | $53.55 | $53.55 |
| CA | $53.48 | $61.28 |
| CO | $57.09 | $61.28 |
| CT | $53.55 | $53.55 |
| DC | $54.39 | $61.28 |
| DE | $54.39 | $61.28 |
| FL | $52.91 | $53.55 |
| GA | $52.91 | $54.88 |
| HI | $70.28 | — |
| IA | $53.79 | $61.28 |
| ID | $57.09 | $61.28 |
| IL | $52.33 | $53.55 |
| IN | $52.33 | $61.28 |
| KS | $53.79 | $61.28 |
| KY | $52.91 | $61.28 |
| LA | $52.91 | $61.28 |
| MA | $56.28 | $61.28 |
| MD | $54.39 | $61.28 |
| ME | $56.28 | $61.28 |
| MI | $52.33 | $57.59 |
| MN | $53.79 | $57.16 |
| MO | $53.79 | $58.72 |
| MS | $52.91 | $60.71 |
| MT | $57.09 | $61.28 |
| NC | $52.91 | $60.25 |
| ND | $53.79 | $59.38 |
| NE | $53.79 | $61.28 |
| NH | $56.28 | $61.28 |
| NJ | $54.39 | $61.28 |
| NM | $54.21 | $61.28 |
| NV | $53.48 | $53.55 |
| NY | $54.39 | $60.39 |
| OH | $52.33 | $53.55 |
| OK | $54.21 | $61.28 |
| OR | $53.48 | $61.28 |
| PA | $54.39 | $60.92 |
| PR | $68.49 | — |
| RI | $56.28 | $61.28 |
| SC | $52.91 | $57.86 |
| SD | $53.79 | $59.91 |
| TN | $52.91 | $60.25 |
| TX | $54.21 | $60.60 |
| UT | $57.09 | $61.28 |
| VA | $52.91 | $53.55 |
| VI | $61.22 | — |
| VT | $56.28 | $61.28 |
| WA | $53.48 | $61.28 |
| WI | $52.33 | $53.55 |
| WV | $52.91 | $53.55 |
| WY | $57.09 | $59.38 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $53.54 to $107.11 depending on state and rural status.
Former-CBA payment limits: ceiling $62.99 · floor $53.54
| State | Non-rural | Rural |
|---|---|---|
| AK | $107.11 | — |
| AL | $53.54 | — |
| AR | $62.99 | — |
| AZ | $53.54 | — |
| CA | $62.99 | — |
| CO | $62.99 | — |
| CT | $53.54 | — |
| DC | $62.99 | — |
| DE | $62.99 | — |
| FL | $53.54 | — |
| GA | $54.89 | — |
| HI | $78.19 | — |
| IA | $62.99 | — |
| ID | $62.99 | — |
| IL | $53.54 | — |
| IN | $62.99 | — |
| KS | $62.99 | — |
| KY | $62.99 | — |
| LA | $62.99 | — |
| MA | $62.99 | — |
| MD | $62.99 | — |
| ME | $62.99 | — |
| MI | $57.58 | — |
| MN | $57.16 | — |
| MO | $58.74 | — |
| MS | $61.85 | — |
| MT | $62.99 | — |
| NC | $60.93 | — |
| ND | $59.38 | — |
| NE | $62.99 | — |
| NH | $62.99 | — |
| NJ | $62.99 | — |
| NM | $62.99 | — |
| NV | $53.54 | — |
| NY | $61.23 | — |
| OH | $53.54 | — |
| OK | $62.99 | — |
| OR | $62.99 | — |
| PA | $62.28 | — |
| PR | $74.61 | — |
| RI | $62.99 | — |
| SC | $57.84 | — |
| SD | $60.25 | — |
| TN | $60.93 | — |
| TX | $61.64 | — |
| UT | $62.99 | — |
| VA | $53.54 | — |
| VI | $61.23 | — |
| VT | $62.99 | — |
| WA | $62.99 | — |
| WI | $53.54 | — |
| WV | $53.54 | — |
| WY | $59.38 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $5.23 to $8.47 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $8.47 | — |
| AL | $5.29 | $5.39 |
| AR | $5.29 | $6.15 |
| AZ | $5.42 | $6.15 |
| CA | $5.35 | $6.15 |
| CO | $5.71 | $6.15 |
| CT | $5.39 | $5.39 |
| DC | $5.44 | $6.15 |
| DE | $5.44 | $6.15 |
| FL | $5.29 | $5.39 |
| GA | $5.29 | $5.47 |
| HI | $7.02 | — |
| IA | $5.38 | $6.15 |
| ID | $5.71 | $6.15 |
| IL | $5.23 | $5.39 |
| IN | $5.23 | $6.15 |
| KS | $5.38 | $6.15 |
| KY | $5.29 | $6.15 |
| LA | $5.29 | $6.15 |
| MA | $5.57 | $5.57 |
| MD | $5.44 | $6.15 |
| ME | $5.57 | $5.57 |
| MI | $5.23 | $5.75 |
| MN | $5.38 | $5.70 |
| MO | $5.38 | $6.15 |
| MS | $5.29 | $6.08 |
| MT | $5.71 | $6.15 |
| NC | $5.29 | $6.03 |
| ND | $5.38 | $5.97 |
| NE | $5.38 | $6.15 |
| NH | $5.63 | $5.64 |
| NJ | $5.44 | $6.15 |
| NM | $5.42 | $6.15 |
| NV | $5.35 | $6.15 |
| NY | $5.44 | $6.03 |
| OH | $5.23 | $5.39 |
| OK | $5.42 | $6.15 |
| OR | $5.35 | $6.15 |
| PA | $5.44 | $6.15 |
| PR | $7.79 | — |
| RI | $5.57 | $5.57 |
| SC | $5.29 | $5.78 |
| SD | $5.38 | $6.01 |
| TN | $5.29 | $6.03 |
| TX | $5.42 | $6.07 |
| UT | $5.71 | $6.15 |
| VA | $5.29 | $5.39 |
| VI | $6.11 | — |
| VT | $5.63 | $6.15 |
| WA | $5.35 | $6.15 |
| WI | $5.23 | $5.39 |
| WV | $5.29 | $5.39 |
| WY | $5.71 | $5.97 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $5.38 to $10.72 depending on state and rural status.
Former-CBA payment limits: ceiling $6.33 · floor $5.38
| State | Non-rural | Rural |
|---|---|---|
| AK | $10.72 | — |
| AL | $5.38 | — |
| AR | $6.33 | — |
| AZ | $6.33 | — |
| CA | $6.33 | — |
| CO | $6.33 | — |
| CT | $5.38 | — |
| DC | $6.33 | — |
| DE | $6.33 | — |
| FL | $5.38 | — |
| GA | $5.48 | — |
| HI | $7.81 | — |
| IA | $6.33 | — |
| ID | $6.33 | — |
| IL | $5.38 | — |
| IN | $6.33 | — |
| KS | $6.33 | — |
| KY | $6.33 | — |
| LA | $6.33 | — |
| MA | $5.58 | — |
| MD | $6.33 | — |
| ME | $5.58 | — |
| MI | $5.74 | — |
| MN | $5.70 | — |
| MO | $6.33 | — |
| MS | $6.19 | — |
| MT | $6.33 | — |
| NC | $6.10 | — |
| ND | $5.99 | — |
| NE | $6.33 | — |
| NH | $5.63 | — |
| NJ | $6.33 | — |
| NM | $6.33 | — |
| NV | $6.33 | — |
| NY | $6.10 | — |
| OH | $5.38 | — |
| OK | $6.33 | — |
| OR | $6.33 | — |
| PA | $6.33 | — |
| PR | $9.34 | — |
| RI | $5.58 | — |
| SC | $5.76 | — |
| SD | $6.05 | — |
| TN | $6.10 | — |
| TX | $6.17 | — |
| UT | $6.33 | — |
| VA | $5.38 | — |
| VI | $6.10 | — |
| VT | $6.33 | — |
| WA | $6.33 | — |
| WI | $5.38 | — |
| WV | $5.38 | — |
| WY | $5.99 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $39.25 to $63.56 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $63.56 | — |
| AL | $39.69 | $40.52 |
| AR | $39.69 | $46.17 |
| AZ | $40.52 | $40.52 |
| CA | $40.11 | $46.17 |
| CO | $42.82 | $46.17 |
| CT | $40.52 | $40.52 |
| DC | $40.79 | $46.17 |
| DE | $40.79 | $46.17 |
| FL | $39.69 | $40.52 |
| GA | $39.69 | $41.11 |
| HI | $52.70 | — |
| IA | $40.34 | $46.17 |
| ID | $42.82 | $46.17 |
| IL | $39.25 | $40.52 |
| IN | $39.25 | $46.17 |
| KS | $40.34 | $46.17 |
| KY | $39.69 | $46.17 |
| LA | $39.69 | $46.17 |
| MA | $42.21 | $46.17 |
| MD | $40.79 | $46.17 |
| ME | $42.21 | $46.17 |
| MI | $39.25 | $43.21 |
| MN | $40.34 | $42.87 |
| MO | $40.34 | $44.01 |
| MS | $39.69 | $45.55 |
| MT | $42.82 | $46.17 |
| NC | $39.69 | $45.19 |
| ND | $40.34 | $44.53 |
| NE | $40.34 | $46.17 |
| NH | $42.21 | $46.17 |
| NJ | $40.79 | $46.17 |
| NM | $40.66 | $46.17 |
| NV | $40.11 | $40.52 |
| NY | $40.79 | $46.17 |
| OH | $39.25 | $40.52 |
| OK | $40.66 | $46.17 |
| OR | $40.11 | $46.17 |
| PA | $40.79 | $46.17 |
| PR | $51.37 | — |
| RI | $42.21 | $46.17 |
| SC | $39.69 | $43.38 |
| SD | $40.34 | $44.94 |
| TN | $39.69 | $45.19 |
| TX | $40.66 | $45.44 |
| UT | $42.82 | $46.05 |
| VA | $39.69 | $40.52 |
| VI | $47.23 | — |
| VT | $42.21 | $46.17 |
| WA | $40.11 | $45.96 |
| WI | $39.25 | $40.52 |
| WV | $39.69 | $40.52 |
| WY | $42.82 | $44.53 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $40.55 to $80.35 depending on state and rural status.
Former-CBA payment limits: ceiling $47.70 · floor $40.55
| State | Non-rural | Rural |
|---|---|---|
| AK | $80.35 | — |
| AL | $40.55 | — |
| AR | $47.70 | — |
| AZ | $40.55 | — |
| CA | $47.70 | — |
| CO | $47.70 | — |
| CT | $40.55 | — |
| DC | $47.70 | — |
| DE | $47.70 | — |
| FL | $40.55 | — |
| GA | $41.11 | — |
| HI | $58.63 | — |
| IA | $47.70 | — |
| ID | $47.70 | — |
| IL | $40.55 | — |
| IN | $47.70 | — |
| KS | $47.70 | — |
| KY | $47.70 | — |
| LA | $47.70 | — |
| MA | $47.70 | — |
| MD | $47.70 | — |
| ME | $47.70 | — |
| MI | $43.20 | — |
| MN | $42.88 | — |
| MO | $44.01 | — |
| MS | $46.44 | — |
| MT | $47.70 | — |
| NC | $45.69 | — |
| ND | $44.50 | — |
| NE | $47.70 | — |
| NH | $47.70 | — |
| NJ | $47.70 | — |
| NM | $47.70 | — |
| NV | $40.55 | — |
| NY | $47.70 | — |
| OH | $40.55 | — |
| OK | $47.70 | — |
| OR | $47.70 | — |
| PA | $47.70 | — |
| PR | $55.98 | — |
| RI | $47.70 | — |
| SC | $43.39 | — |
| SD | $45.22 | — |
| TN | $45.69 | — |
| TX | $46.23 | — |
| UT | $47.42 | — |
| VA | $40.55 | — |
| VI | $47.70 | — |
| VT | $47.70 | — |
| WA | $47.27 | — |
| WI | $40.55 | — |
| WV | $40.55 | — |
| WY | $44.50 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E0959 at 2 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
Related E-codes
Bill E0959 with confidence
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