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E0967 — Manual wheelchair accessory, hand rim with projections, any type, replacement only, each

HCPCS Level II E-code · short descriptor: “Man wc rim/projection rep ea”

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.

E0967 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $83.53 to $105.02 depending on state and rural status.

StateNon-ruralRural
AK$92.06
AL$88.62$93.60
AR$88.62$93.60
AZ$87.64$92.06
CA$83.53$92.06
CO$90.92$93.60
CT$91.02$93.60
DC$86.82$93.60
DE$86.82$93.56
FL$88.62$93.56
GA$88.62$93.60
HI$92.06
IA$90.41$92.06
ID$90.92$92.06
IL$90.27$93.60
IN$90.27$93.60
KS$90.41$92.06
KY$88.62$93.60
LA$88.62$93.60
MA$91.02$93.60
MD$86.82$93.60
ME$91.02$93.60
MI$90.27$93.60
MN$90.41$93.60
MO$90.41$93.60
MS$88.62$93.60
MT$90.92$92.06
NC$88.62$93.60
ND$90.41$92.06
NE$90.41$92.06
NH$91.02$93.56
NJ$86.82$93.56
NM$87.64$93.60
NV$83.53$92.06
NY$86.82$93.56
OH$90.27$93.60
OK$87.64$93.60
OR$83.53$92.06
PA$86.82$93.56
PR$105.02
RI$91.02$93.56
SC$88.62$93.60
SD$90.41$92.06
TN$88.62$93.60
TX$87.64$93.56
UT$90.92$93.60
VA$88.62$93.60
VI$93.56
VT$91.02$93.60
WA$83.53$93.60
WI$90.27$93.60
WV$88.62$93.60
WY$90.92$92.06

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $92.03 to $112.32 depending on state and rural status.

Former-CBA payment limits: ceiling $93.60 · floor $79.56

StateNon-ruralRural
AK$92.03
AL$93.60
AR$93.60
AZ$92.03
CA$92.03
CO$93.60
CT$93.60
DC$93.60
DE$93.56
FL$93.56
GA$93.60
HI$92.03
IA$92.03
ID$92.03
IL$93.60
IN$93.60
KS$92.03
KY$93.60
LA$93.60
MA$93.60
MD$93.60
ME$93.60
MI$93.60
MN$93.60
MO$93.60
MS$93.60
MT$92.03
NC$93.60
ND$92.03
NE$92.03
NH$93.56
NJ$93.56
NM$93.60
NV$92.03
NY$93.56
OH$93.60
OK$93.60
OR$92.03
PA$93.56
PR$112.32
RI$93.56
SC$93.60
SD$92.03
TN$93.60
TX$93.56
UT$93.60
VA$93.60
VI$93.56
VT$93.60
WA$93.60
WI$93.60
WV$93.60
WY$92.03

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $8.35 to $10.49 depending on state and rural status.

StateNon-ruralRural
AK$9.21
AL$8.86$9.37
AR$8.86$9.37
AZ$8.76$9.21
CA$8.35$9.21
CO$9.09$9.37
CT$9.10$9.37
DC$8.68$9.37
DE$8.68$9.36
FL$8.86$9.36
GA$8.86$9.37
HI$9.21
IA$9.04$9.21
ID$9.09$9.21
IL$9.03$9.37
IN$9.03$9.37
KS$9.04$9.21
KY$8.86$9.37
LA$8.86$9.37
MA$9.10$9.37
MD$8.68$9.37
ME$9.10$9.37
MI$9.03$9.37
MN$9.04$9.37
MO$9.04$9.37
MS$8.86$9.37
MT$9.09$9.21
NC$8.86$9.37
ND$9.04$9.21
NE$9.04$9.21
NH$9.10$9.36
NJ$8.68$9.36
NM$8.76$9.37
NV$8.35$9.21
NY$8.68$9.36
OH$9.03$9.37
OK$8.76$9.37
OR$8.35$9.21
PA$8.68$9.36
PR$10.49
RI$9.10$9.36
SC$8.86$9.37
SD$9.04$9.21
TN$8.86$9.37
TX$8.76$9.36
UT$9.09$9.37
VA$8.86$9.37
VI$9.36
VT$9.10$9.37
WA$8.35$9.37
WI$9.03$9.37
WV$8.86$9.37
WY$9.09$9.21

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $9.21 to $11.21 depending on state and rural status.

Former-CBA payment limits: ceiling $9.38 · floor $7.97

StateNon-ruralRural
AK$9.21
AL$9.38
AR$9.38
AZ$9.21
CA$9.21
CO$9.38
CT$9.38
DC$9.38
DE$9.37
FL$9.37
GA$9.38
HI$9.21
IA$9.21
ID$9.21
IL$9.38
IN$9.38
KS$9.21
KY$9.38
LA$9.38
MA$9.38
MD$9.38
ME$9.38
MI$9.38
MN$9.38
MO$9.38
MS$9.38
MT$9.21
NC$9.38
ND$9.21
NE$9.21
NH$9.37
NJ$9.37
NM$9.38
NV$9.21
NY$9.37
OH$9.38
OK$9.38
OR$9.21
PA$9.37
PR$11.21
RI$9.37
SC$9.38
SD$9.21
TN$9.38
TX$9.37
UT$9.38
VA$9.38
VI$9.37
VT$9.38
WA$9.38
WI$9.38
WV$9.38
WY$9.21

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $62.65 to $78.79 depending on state and rural status.

StateNon-ruralRural
AK$69.01
AL$66.46$70.18
AR$66.46$70.18
AZ$65.73$69.01
CA$62.65$69.01
CO$68.19$70.18
CT$68.26$70.18
DC$65.12$70.18
DE$65.12$70.18
FL$66.46$70.18
GA$66.46$70.18
HI$69.01
IA$67.81$69.01
ID$68.19$69.01
IL$67.70$70.18
IN$67.70$70.18
KS$67.81$69.01
KY$66.46$70.18
LA$66.46$70.18
MA$68.26$70.18
MD$65.12$70.18
ME$68.26$70.18
MI$67.70$70.18
MN$67.81$70.18
MO$67.81$70.18
MS$66.46$70.18
MT$68.19$69.01
NC$66.46$70.18
ND$67.81$69.01
NE$67.81$69.01
NH$68.26$70.18
NJ$65.12$70.18
NM$65.73$70.18
NV$62.65$69.01
NY$65.12$70.18
OH$67.70$70.18
OK$65.73$70.18
OR$62.65$69.01
PA$65.12$70.18
PR$78.79
RI$68.26$70.18
SC$66.46$70.18
SD$67.81$69.01
TN$66.46$70.18
TX$65.73$70.18
UT$68.19$70.18
VA$66.46$70.18
VI$70.18
VT$68.26$70.18
WA$62.65$70.18
WI$67.70$70.18
WV$66.46$70.18
WY$68.19$69.01

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $68.99 to $84.26 depending on state and rural status.

Former-CBA payment limits: ceiling $70.16 · floor $59.64

StateNon-ruralRural
AK$68.99
AL$70.16
AR$70.16
AZ$68.99
CA$68.99
CO$70.16
CT$70.16
DC$70.16
DE$70.16
FL$70.16
GA$70.16
HI$68.99
IA$68.99
ID$68.99
IL$70.16
IN$70.16
KS$68.99
KY$70.16
LA$70.16
MA$70.16
MD$70.16
ME$70.16
MI$70.16
MN$70.16
MO$70.16
MS$70.16
MT$68.99
NC$70.16
ND$68.99
NE$68.99
NH$70.16
NJ$70.16
NM$70.16
NV$68.99
NY$70.16
OH$70.16
OK$70.16
OR$68.99
PA$70.16
PR$84.26
RI$70.16
SC$70.16
SD$68.99
TN$70.16
TX$70.16
UT$70.16
VA$70.16
VI$70.16
VT$70.16
WA$70.16
WI$70.16
WV$70.16
WY$68.99
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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.

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