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E2215 — Manual wheelchair accessory, tube for pneumatic caster tire, any size, each

HCPCS Level II E-code · short descriptor: “Pneumatic caster tire tube”

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
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.

E2215 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $11.75 to $15.07 depending on state and rural status.

StateNon-ruralRural
AK$13.46
AL$12.34$13.67
AR$12.34$13.67
AZ$12.12$13.46
CA$11.75$13.46
CO$12.48$13.67
CT$12.95$13.67
DC$12.20$13.67
DE$12.20$13.67
FL$12.34$13.67
GA$12.34$13.67
HI$13.46
IA$12.84$13.46
ID$12.48$13.46
IL$12.83$13.67
IN$12.83$13.67
KS$12.84$13.46
KY$12.34$13.67
LA$12.34$13.67
MA$12.95$13.67
MD$12.20$13.67
ME$12.95$13.67
MI$12.83$13.67
MN$12.84$13.67
MO$12.84$13.67
MS$12.34$13.67
MT$12.48$13.46
NC$12.34$13.67
ND$12.84$13.46
NE$12.84$13.46
NH$12.95$13.67
NJ$12.20$13.67
NM$12.12$13.67
NV$11.75$13.46
NY$12.20$13.67
OH$12.83$13.67
OK$12.12$13.67
OR$11.75$13.46
PA$12.20$13.67
PR$15.07
RI$12.95$13.67
SC$12.34$13.67
SD$12.84$13.46
TN$12.34$13.67
TX$12.12$13.67
UT$12.48$13.67
VA$12.34$13.67
VI$13.67
VT$12.95$13.67
WA$11.75$13.46
WI$12.83$13.67
WV$12.34$13.67
WY$12.48$13.46

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $13.45 to $16.43 depending on state and rural status.

Former-CBA payment limits: ceiling $13.67 · floor $11.62

StateNon-ruralRural
AK$13.45
AL$13.67
AR$13.67
AZ$13.45
CA$13.45
CO$13.67
CT$13.67
DC$13.67
DE$13.67
FL$13.67
GA$13.67
HI$13.45
IA$13.45
ID$13.45
IL$13.67
IN$13.67
KS$13.45
KY$13.67
LA$13.67
MA$13.67
MD$13.67
ME$13.67
MI$13.67
MN$13.67
MO$13.67
MS$13.67
MT$13.45
NC$13.67
ND$13.45
NE$13.45
NH$13.67
NJ$13.67
NM$13.67
NV$13.45
NY$13.67
OH$13.67
OK$13.67
OR$13.45
PA$13.67
PR$16.43
RI$13.67
SC$13.67
SD$13.45
TN$13.67
TX$13.67
UT$13.67
VA$13.67
VI$13.67
VT$13.67
WA$13.45
WI$13.67
WV$13.67
WY$13.45

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $1.18 to $1.51 depending on state and rural status.

StateNon-ruralRural
AK$1.35
AL$1.23$1.36
AR$1.23$1.36
AZ$1.21$1.35
CA$1.18$1.35
CO$1.25$1.36
CT$1.30$1.36
DC$1.22$1.36
DE$1.22$1.36
FL$1.23$1.36
GA$1.23$1.36
HI$1.35
IA$1.28$1.35
ID$1.25$1.35
IL$1.28$1.36
IN$1.28$1.36
KS$1.28$1.35
KY$1.23$1.36
LA$1.23$1.36
MA$1.30$1.36
MD$1.22$1.36
ME$1.30$1.36
MI$1.28$1.36
MN$1.28$1.36
MO$1.28$1.36
MS$1.23$1.36
MT$1.25$1.35
NC$1.23$1.36
ND$1.28$1.35
NE$1.28$1.35
NH$1.30$1.36
NJ$1.22$1.36
NM$1.21$1.36
NV$1.18$1.35
NY$1.22$1.36
OH$1.28$1.36
OK$1.21$1.36
OR$1.18$1.35
PA$1.22$1.36
PR$1.51
RI$1.30$1.36
SC$1.23$1.36
SD$1.28$1.35
TN$1.23$1.36
TX$1.21$1.36
UT$1.25$1.36
VA$1.23$1.36
VI$1.36
VT$1.30$1.36
WA$1.18$1.35
WI$1.28$1.36
WV$1.23$1.36
WY$1.25$1.35

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $1.35 to $1.64 depending on state and rural status.

Former-CBA payment limits: ceiling $1.36 · floor $1.16

StateNon-ruralRural
AK$1.35
AL$1.36
AR$1.36
AZ$1.35
CA$1.35
CO$1.36
CT$1.36
DC$1.36
DE$1.36
FL$1.36
GA$1.36
HI$1.35
IA$1.35
ID$1.35
IL$1.36
IN$1.36
KS$1.35
KY$1.36
LA$1.36
MA$1.36
MD$1.36
ME$1.36
MI$1.36
MN$1.36
MO$1.36
MS$1.36
MT$1.35
NC$1.36
ND$1.35
NE$1.35
NH$1.36
NJ$1.36
NM$1.36
NV$1.35
NY$1.36
OH$1.36
OK$1.36
OR$1.35
PA$1.36
PR$1.64
RI$1.36
SC$1.36
SD$1.35
TN$1.36
TX$1.36
UT$1.36
VA$1.36
VI$1.36
VT$1.36
WA$1.35
WI$1.36
WV$1.36
WY$1.35

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $8.82 to $11.28 depending on state and rural status.

StateNon-ruralRural
AK$10.09
AL$9.26$10.23
AR$9.26$10.23
AZ$9.09$10.09
CA$8.82$10.09
CO$9.36$10.23
CT$9.72$10.23
DC$9.15$10.23
DE$9.15$10.23
FL$9.26$10.23
GA$9.26$10.23
HI$10.09
IA$9.63$10.09
ID$9.36$10.09
IL$9.62$10.23
IN$9.62$10.23
KS$9.63$10.09
KY$9.26$10.23
LA$9.26$10.23
MA$9.72$10.23
MD$9.15$10.23
ME$9.72$10.23
MI$9.62$10.23
MN$9.63$10.23
MO$9.63$10.23
MS$9.26$10.23
MT$9.36$10.09
NC$9.26$10.23
ND$9.63$10.09
NE$9.63$10.09
NH$9.72$10.23
NJ$9.15$10.23
NM$9.09$10.23
NV$8.82$10.09
NY$9.15$10.23
OH$9.62$10.23
OK$9.09$10.23
OR$8.82$10.09
PA$9.15$10.23
PR$11.28
RI$9.72$10.23
SC$9.26$10.23
SD$9.63$10.09
TN$9.26$10.23
TX$9.09$10.23
UT$9.36$10.23
VA$9.26$10.23
VI$10.23
VT$9.72$10.23
WA$8.82$10.09
WI$9.62$10.23
WV$9.26$10.23
WY$9.36$10.09

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $10.08 to $12.27 depending on state and rural status.

Former-CBA payment limits: ceiling $10.26 · floor $8.72

StateNon-ruralRural
AK$10.08
AL$10.26
AR$10.26
AZ$10.08
CA$10.08
CO$10.26
CT$10.26
DC$10.26
DE$10.26
FL$10.26
GA$10.26
HI$10.08
IA$10.08
ID$10.08
IL$10.26
IN$10.26
KS$10.08
KY$10.26
LA$10.26
MA$10.26
MD$10.26
ME$10.26
MI$10.26
MN$10.26
MO$10.26
MS$10.26
MT$10.08
NC$10.26
ND$10.08
NE$10.08
NH$10.26
NJ$10.26
NM$10.26
NV$10.08
NY$10.26
OH$10.26
OK$10.26
OR$10.08
PA$10.26
PR$12.27
RI$10.26
SC$10.26
SD$10.08
TN$10.26
TX$10.26
UT$10.26
VA$10.26
VI$10.26
VT$10.26
WA$10.08
WI$10.26
WV$10.26
WY$10.08
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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