MyMedi-AI

E2209 — Accessory, arm trough, with or without hand support, each

HCPCS Level II E-code · short descriptor: “Arm trough each”

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 2026-10-26; 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 2026-10-26; 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.

E2209 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $95.35 to $143.01 depending on state and rural status.

StateNon-ruralRural
AK$128.75—
AL$100.76$121.64
AR$100.76$121.64
AZ$99.08$120.55
CA$95.35$120.55
CO$100.05$121.64
CT$107.15$121.64
DC$100.73$121.64
DE$100.73$121.64
FL$100.76$121.64
GA$100.76$121.64
HI$128.75—
IA$101.30$120.55
ID$100.05$120.55
IL$106.05$121.64
IN$106.05$121.64
KS$101.30$120.55
KY$100.76$121.64
LA$100.76$121.64
MA$107.15$121.64
MD$100.73$121.64
ME$107.15$121.64
MI$106.05$121.64
MN$101.30$121.64
MO$101.30$121.64
MS$100.76$121.64
MT$100.05$120.55
NC$100.76$121.64
ND$101.30$120.55
NE$101.30$120.55
NH$107.15$121.64
NJ$100.73$121.64
NM$99.08$121.64
NV$95.35$120.55
NY$100.73$121.64
OH$106.05$121.64
OK$99.08$121.64
OR$95.35$120.55
PA$100.73$121.64
PR$143.01—
RI$107.15$121.64
SC$100.76$121.64
SD$101.30$120.55
TN$100.76$121.64
TX$99.08$121.64
UT$100.05$121.64
VA$100.76$121.64
VI$129.84—
VT$107.15$121.64
WA$95.35$121.64
WI$106.05$121.64
WV$100.76$121.64
WY$100.05$120.55

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $129.94 to $154.46 depending on state and rural status.

StateNon-ruralRural
AK$138.14—
AL—$131.19
AR—$131.19
AZ—$129.94
CA—$129.94
CO—$131.19
CT—$131.19
DC—$131.19
DE—$131.19
FL—$131.19
GA—$131.19
HI$138.14—
IA—$129.94
ID—$129.94
IL—$131.19
IN—$131.19
KS—$129.94
KY—$131.19
LA—$131.19
MA—$131.19
MD—$131.19
ME—$131.19
MI—$131.19
MN—$131.19
MO—$131.19
MS—$131.19
MT—$129.94
NC—$131.19
ND—$129.94
NE—$129.94
NH—$131.19
NJ—$131.19
NM—$131.19
NV—$129.94
NY—$131.19
OH—$131.19
OK—$131.19
OR—$129.94
PA—$131.19
PR$154.46—
RI—$131.19
SC—$131.19
SD—$129.94
TN—$131.19
TX—$131.19
UT—$131.19
VA—$131.19
VI$139.39—
VT—$131.19
WA—$131.19
WI—$131.19
WV—$131.19
WY—$129.94

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $129.44 to $157.98 depending on state and rural status.

Former-CBA payment limits: ceiling $131.61 · floor $111.87

StateNon-ruralRural
AK$129.44—
AL$131.61—
AR$131.61—
AZ$129.44—
CA$129.44—
CO$131.61—
CT$131.61—
DC$131.61—
DE$131.61—
FL$131.61—
GA$131.61—
HI$129.44—
IA$129.44—
ID$129.44—
IL$131.61—
IN$131.61—
KS$129.44—
KY$131.61—
LA$131.61—
MA$131.61—
MD$131.61—
ME$131.61—
MI$131.61—
MN$131.61—
MO$131.61—
MS$131.61—
MT$129.44—
NC$131.61—
ND$129.44—
NE$129.44—
NH$131.61—
NJ$131.61—
NM$131.61—
NV$129.44—
NY$131.61—
OH$131.61—
OK$131.61—
OR$129.44—
PA$131.61—
PR$157.98—
RI$131.61—
SC$131.61—
SD$129.44—
TN$131.61—
TX$131.61—
UT$131.61—
VA$131.61—
VI$131.61—
VT$131.61—
WA$131.61—
WI$131.61—
WV$131.61—
WY$129.44—

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $9.54 to $14.31 depending on state and rural status.

StateNon-ruralRural
AK$12.87—
AL$10.08$12.18
AR$10.08$12.18
AZ$9.91$12.05
CA$9.54$12.05
CO$10.01$12.18
CT$10.72$12.18
DC$10.07$12.18
DE$10.07$12.18
FL$10.08$12.18
GA$10.08$12.18
HI$12.87—
IA$10.13$12.05
ID$10.01$12.05
IL$10.61$12.18
IN$10.61$12.18
KS$10.13$12.05
KY$10.08$12.18
LA$10.08$12.18
MA$10.72$12.18
MD$10.07$12.18
ME$10.72$12.18
MI$10.61$12.18
MN$10.13$12.18
MO$10.13$12.18
MS$10.08$12.18
MT$10.01$12.05
NC$10.08$12.18
ND$10.13$12.05
NE$10.13$12.05
NH$10.72$12.18
NJ$10.07$12.18
NM$9.91$12.18
NV$9.54$12.05
NY$10.07$12.18
OH$10.61$12.18
OK$9.91$12.18
OR$9.54$12.05
PA$10.07$12.18
PR$14.31—
RI$10.72$12.18
SC$10.08$12.18
SD$10.13$12.05
TN$10.08$12.18
TX$9.91$12.18
UT$10.01$12.18
VA$10.08$12.18
VI$13.00—
VT$10.72$12.18
WA$9.54$12.18
WI$10.61$12.18
WV$10.08$12.18
WY$10.01$12.05

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $12.99 to $15.45 depending on state and rural status.

StateNon-ruralRural
AK$13.80—
AL—$13.13
AR—$13.13
AZ—$12.99
CA—$12.99
CO—$13.13
CT—$13.13
DC—$13.13
DE—$13.13
FL—$13.13
GA—$13.13
HI$13.80—
IA—$12.99
ID—$12.99
IL—$13.13
IN—$13.13
KS—$12.99
KY—$13.13
LA—$13.13
MA—$13.13
MD—$13.13
ME—$13.13
MI—$13.13
MN—$13.13
MO—$13.13
MS—$13.13
MT—$12.99
NC—$13.13
ND—$12.99
NE—$12.99
NH—$13.13
NJ—$13.13
NM—$13.13
NV—$12.99
NY—$13.13
OH—$13.13
OK—$13.13
OR—$12.99
PA—$13.13
PR$15.45—
RI—$13.13
SC—$13.13
SD—$12.99
TN—$13.13
TX—$13.13
UT—$13.13
VA—$13.13
VI$13.95—
VT—$13.13
WA—$13.13
WI—$13.13
WV—$13.13
WY—$12.99

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $12.91 to $15.82 depending on state and rural status.

Former-CBA payment limits: ceiling $13.18 · floor $11.20

StateNon-ruralRural
AK$12.91—
AL$13.18—
AR$13.18—
AZ$12.91—
CA$12.91—
CO$13.18—
CT$13.18—
DC$13.18—
DE$13.18—
FL$13.18—
GA$13.18—
HI$12.91—
IA$12.91—
ID$12.91—
IL$13.18—
IN$13.18—
KS$12.91—
KY$13.18—
LA$13.18—
MA$13.18—
MD$13.18—
ME$13.18—
MI$13.18—
MN$13.18—
MO$13.18—
MS$13.18—
MT$12.91—
NC$13.18—
ND$12.91—
NE$12.91—
NH$13.18—
NJ$13.18—
NM$13.18—
NV$12.91—
NY$13.18—
OH$13.18—
OK$13.18—
OR$12.91—
PA$13.18—
PR$15.82—
RI$13.18—
SC$13.18—
SD$12.91—
TN$13.18—
TX$13.18—
UT$13.18—
VA$13.18—
VI$13.18—
VT$13.18—
WA$13.18—
WI$13.18—
WV$13.18—
WY$12.91—

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $71.52 to $107.26 depending on state and rural status.

StateNon-ruralRural
AK$96.57—
AL$75.57$91.24
AR$75.57$91.24
AZ$74.31$90.42
CA$71.52$90.42
CO$75.04$91.24
CT$80.36$91.24
DC$75.55$91.24
DE$75.55$91.24
FL$75.57$91.24
GA$75.57$91.24
HI$96.57—
IA$75.98$90.42
ID$75.04$90.42
IL$79.54$91.24
IN$79.54$91.24
KS$75.98$90.42
KY$75.57$91.24
LA$75.57$91.24
MA$80.36$91.24
MD$75.55$91.24
ME$80.36$91.24
MI$79.54$91.24
MN$75.98$91.24
MO$75.98$91.24
MS$75.57$91.24
MT$75.04$90.42
NC$75.57$91.24
ND$75.98$90.42
NE$75.98$90.42
NH$80.36$91.24
NJ$75.55$91.24
NM$74.31$91.24
NV$71.52$90.42
NY$75.55$91.24
OH$79.54$91.24
OK$74.31$91.24
OR$71.52$90.42
PA$75.55$91.24
PR$107.26—
RI$80.36$91.24
SC$75.57$91.24
SD$75.98$90.42
TN$75.57$91.24
TX$74.31$91.24
UT$75.04$91.24
VA$75.57$91.24
VI$97.39—
VT$80.36$91.24
WA$71.52$91.24
WI$79.54$91.24
WV$75.57$91.24
WY$75.04$90.42

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $97.46 to $115.85 depending on state and rural status.

StateNon-ruralRural
AK$103.61—
AL—$98.40
AR—$98.40
AZ—$97.46
CA—$97.46
CO—$98.40
CT—$98.40
DC—$98.40
DE—$98.40
FL—$98.40
GA—$98.40
HI$103.61—
IA—$97.46
ID—$97.46
IL—$98.40
IN—$98.40
KS—$97.46
KY—$98.40
LA—$98.40
MA—$98.40
MD—$98.40
ME—$98.40
MI—$98.40
MN—$98.40
MO—$98.40
MS—$98.40
MT—$97.46
NC—$98.40
ND—$97.46
NE—$97.46
NH—$98.40
NJ—$98.40
NM—$98.40
NV—$97.46
NY—$98.40
OH—$98.40
OK—$98.40
OR—$97.46
PA—$98.40
PR$115.85—
RI—$98.40
SC—$98.40
SD—$97.46
TN—$98.40
TX—$98.40
UT—$98.40
VA—$98.40
VI$104.55—
VT—$98.40
WA—$98.40
WI—$98.40
WV—$98.40
WY—$97.46

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $97.11 to $118.45 depending on state and rural status.

Former-CBA payment limits: ceiling $98.74 · floor $83.93

StateNon-ruralRural
AK$97.11—
AL$98.74—
AR$98.74—
AZ$97.11—
CA$97.11—
CO$98.74—
CT$98.74—
DC$98.74—
DE$98.74—
FL$98.74—
GA$98.74—
HI$97.11—
IA$97.11—
ID$97.11—
IL$98.74—
IN$98.74—
KS$97.11—
KY$98.74—
LA$98.74—
MA$98.74—
MD$98.74—
ME$98.74—
MI$98.74—
MN$98.74—
MO$98.74—
MS$98.74—
MT$97.11—
NC$98.74—
ND$97.11—
NE$97.11—
NH$98.74—
NJ$98.74—
NM$98.74—
NV$97.11—
NY$98.74—
OH$98.74—
OK$98.74—
OR$97.11—
PA$98.74—
PR$118.45—
RI$98.74—
SC$98.74—
SD$97.11—
TN$98.74—
TX$98.74—
UT$98.74—
VA$98.74—
VI$98.74—
VT$98.74—
WA$98.74—
WI$98.74—
WV$98.74—
WY$97.11—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps E2209 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related E-codes

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