MyMedi-AI

E2226 — Manual wheelchair accessory, caster fork, any size, replacement only, each

HCPCS Level II E-code · short descriptor: “Caster fork replacement only”

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.

E2226 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $45.21 to $59.34 depending on state and rural status.

StateNon-ruralRural
AK$53.93—
AL$47.54$53.26
AR$47.54$53.26
AZ$47.00$53.26
CA$45.21$53.26
CO$47.29$53.26
CT$49.08$53.26
DC$46.65$53.26
DE$46.65$53.26
FL$47.54$53.26
GA$47.54$53.26
HI$53.93—
IA$47.92$53.26
ID$47.29$53.26
IL$50.14$53.26
IN$50.14$53.26
KS$47.92$53.26
KY$47.54$53.26
LA$47.54$53.26
MA$49.08$53.26
MD$46.65$53.26
ME$49.08$53.26
MI$50.14$53.26
MN$47.92$53.26
MO$47.92$53.26
MS$47.54$53.26
MT$47.29$53.26
NC$47.54$53.26
ND$47.92$53.26
NE$47.92$53.26
NH$49.08$53.26
NJ$46.65$53.26
NM$47.00$53.26
NV$45.21$53.26
NY$46.65$53.26
OH$50.14$53.26
OK$47.00$53.26
OR$45.21$53.26
PA$46.65$53.26
PR$59.34—
RI$49.08$53.26
SC$47.54$53.26
SD$47.92$53.26
TN$47.54$53.26
TX$47.00$53.26
UT$47.29$53.26
VA$47.54$53.26
VI$53.93—
VT$49.08$53.26
WA$45.21$53.26
WI$50.14$53.26
WV$47.54$53.26
WY$47.29$53.26

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $54.06 to $64.90 depending on state and rural status.

Former-CBA payment limits: ceiling $54.06 · floor $45.95

StateNon-ruralRural
AK$54.06—
AL$54.06—
AR$54.06—
AZ$54.06—
CA$54.06—
CO$54.06—
CT$54.06—
DC$54.06—
DE$54.06—
FL$54.06—
GA$54.06—
HI$54.06—
IA$54.06—
ID$54.06—
IL$54.06—
IN$54.06—
KS$54.06—
KY$54.06—
LA$54.06—
MA$54.06—
MD$54.06—
ME$54.06—
MI$54.06—
MN$54.06—
MO$54.06—
MS$54.06—
MT$54.06—
NC$54.06—
ND$54.06—
NE$54.06—
NH$54.06—
NJ$54.06—
NM$54.06—
NV$54.06—
NY$54.06—
OH$54.06—
OK$54.06—
OR$54.06—
PA$54.06—
PR$64.90—
RI$54.06—
SC$54.06—
SD$54.06—
TN$54.06—
TX$54.06—
UT$54.06—
VA$54.06—
VI$54.06—
VT$54.06—
WA$54.06—
WI$54.06—
WV$54.06—
WY$54.06—

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $4.52 to $5.93 depending on state and rural status.

StateNon-ruralRural
AK$5.39—
AL$4.75$5.33
AR$4.75$5.33
AZ$4.70$5.33
CA$4.52$5.33
CO$4.73$5.33
CT$4.91$5.33
DC$4.67$5.33
DE$4.67$5.33
FL$4.75$5.33
GA$4.75$5.33
HI$5.39—
IA$4.79$5.33
ID$4.73$5.33
IL$5.01$5.33
IN$5.01$5.33
KS$4.79$5.33
KY$4.75$5.33
LA$4.75$5.33
MA$4.91$5.33
MD$4.67$5.33
ME$4.91$5.33
MI$5.01$5.33
MN$4.79$5.33
MO$4.79$5.33
MS$4.75$5.33
MT$4.73$5.33
NC$4.75$5.33
ND$4.79$5.33
NE$4.79$5.33
NH$4.91$5.33
NJ$4.67$5.33
NM$4.70$5.33
NV$4.52$5.33
NY$4.67$5.33
OH$5.01$5.33
OK$4.70$5.33
OR$4.52$5.33
PA$4.67$5.33
PR$5.93—
RI$4.91$5.33
SC$4.75$5.33
SD$4.79$5.33
TN$4.75$5.33
TX$4.70$5.33
UT$4.73$5.33
VA$4.75$5.33
VI$5.39—
VT$4.91$5.33
WA$4.52$5.33
WI$5.01$5.33
WV$4.75$5.33
WY$4.73$5.33

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $5.41 to $6.51 depending on state and rural status.

Former-CBA payment limits: ceiling $5.41 · floor $4.60

StateNon-ruralRural
AK$5.41—
AL$5.41—
AR$5.41—
AZ$5.41—
CA$5.41—
CO$5.41—
CT$5.41—
DC$5.41—
DE$5.41—
FL$5.41—
GA$5.41—
HI$5.41—
IA$5.41—
ID$5.41—
IL$5.41—
IN$5.41—
KS$5.41—
KY$5.41—
LA$5.41—
MA$5.41—
MD$5.41—
ME$5.41—
MI$5.41—
MN$5.41—
MO$5.41—
MS$5.41—
MT$5.41—
NC$5.41—
ND$5.41—
NE$5.41—
NH$5.41—
NJ$5.41—
NM$5.41—
NV$5.41—
NY$5.41—
OH$5.41—
OK$5.41—
OR$5.41—
PA$5.41—
PR$6.51—
RI$5.41—
SC$5.41—
SD$5.41—
TN$5.41—
TX$5.41—
UT$5.41—
VA$5.41—
VI$5.41—
VT$5.41—
WA$5.41—
WI$5.41—
WV$5.41—
WY$5.41—

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $33.91 to $44.50 depending on state and rural status.

StateNon-ruralRural
AK$40.45—
AL$35.66$39.95
AR$35.66$39.95
AZ$35.25$39.95
CA$33.91$39.95
CO$35.47$39.95
CT$36.81$39.95
DC$34.99$39.95
DE$34.99$39.95
FL$35.66$39.95
GA$35.66$39.95
HI$40.45—
IA$35.94$39.95
ID$35.47$39.95
IL$37.61$39.95
IN$37.61$39.95
KS$35.94$39.95
KY$35.66$39.95
LA$35.66$39.95
MA$36.81$39.95
MD$34.99$39.95
ME$36.81$39.95
MI$37.61$39.95
MN$35.94$39.95
MO$35.94$39.95
MS$35.66$39.95
MT$35.47$39.95
NC$35.66$39.95
ND$35.94$39.95
NE$35.94$39.95
NH$36.81$39.95
NJ$34.99$39.95
NM$35.25$39.95
NV$33.91$39.95
NY$34.99$39.95
OH$37.61$39.95
OK$35.25$39.95
OR$33.91$39.95
PA$34.99$39.95
PR$44.50—
RI$36.81$39.95
SC$35.66$39.95
SD$35.94$39.95
TN$35.66$39.95
TX$35.25$39.95
UT$35.47$39.95
VA$35.66$39.95
VI$40.45—
VT$36.81$39.95
WA$33.91$39.95
WI$37.61$39.95
WV$35.66$39.95
WY$35.47$39.95

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $40.56 to $48.65 depending on state and rural status.

Former-CBA payment limits: ceiling $40.56 · floor $34.48

StateNon-ruralRural
AK$40.56—
AL$40.56—
AR$40.56—
AZ$40.56—
CA$40.56—
CO$40.56—
CT$40.56—
DC$40.56—
DE$40.56—
FL$40.56—
GA$40.56—
HI$40.56—
IA$40.56—
ID$40.56—
IL$40.56—
IN$40.56—
KS$40.56—
KY$40.56—
LA$40.56—
MA$40.56—
MD$40.56—
ME$40.56—
MI$40.56—
MN$40.56—
MO$40.56—
MS$40.56—
MT$40.56—
NC$40.56—
ND$40.56—
NE$40.56—
NH$40.56—
NJ$40.56—
NM$40.56—
NV$40.56—
NY$40.56—
OH$40.56—
OK$40.56—
OR$40.56—
PA$40.56—
PR$48.65—
RI$40.56—
SC$40.56—
SD$40.56—
TN$40.56—
TX$40.56—
UT$40.56—
VA$40.56—
VI$40.56—
VT$40.56—
WA$40.56—
WI$40.56—
WV$40.56—
WY$40.56—
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 E2226 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Nature of Equipment.

Common denial codes to watch

Related E-codes

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