MyMedi-AI

E2369 — Power wheelchair component, drive wheel gear box, replacement only

HCPCS Level II E-code · short descriptor: “Pwr wc drivewheel gear repl”

Code system
HCPCS Level II
Family
E — Durable medical equipment
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Capped rental
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.

E2369 Medicare fee schedule (October 2026)

RR — Monthly rental Capped rental

Medicare allowable ranges from $44.86 to $60.70 depending on state and rural status.

StateNon-ruralRural
AK$55.18—
AL$46.72$53.56
AR$46.72$53.56
AZ$45.19$53.56
CA$45.92$53.56
CO$48.03$53.56
CT$49.57$53.56
DC$44.86$53.56
DE$44.86$53.56
FL$46.72$53.56
GA$46.72$53.56
HI$55.18—
IA$46.46$53.56
ID$48.03$53.56
IL$50.36$53.56
IN$50.36$53.56
KS$46.46$53.56
KY$46.72$53.56
LA$46.72$53.56
MA$49.57$53.56
MD$44.86$53.56
ME$49.57$53.56
MI$50.36$53.56
MN$46.46$53.56
MO$46.46$53.56
MS$46.72$53.56
MT$48.03$53.56
NC$46.72$53.56
ND$46.46$53.56
NE$46.46$53.56
NH$49.57$53.56
NJ$44.86$53.56
NM$45.19$53.56
NV$45.92$53.56
NY$44.86$53.56
OH$50.36$53.56
OK$45.19$53.56
OR$45.92$53.56
PA$44.86$53.56
PR$60.70—
RI$49.57$53.56
SC$46.72$53.56
SD$46.46$53.56
TN$46.72$53.56
TX$45.19$53.56
UT$48.03$53.56
VA$46.72$53.56
VI$55.18—
VT$49.57$53.56
WA$45.92$53.56
WI$50.36$53.56
WV$46.72$53.56
WY$48.03$53.56

RR + KE — Monthly rental Capped rental

Medicare allowable ranges from $57.57 to $65.51 depending on state and rural status.

StateNon-ruralRural
AK$59.18—
AL—$57.57
AR—$57.57
AZ—$57.57
CA—$57.57
CO—$57.57
CT—$57.57
DC—$57.57
DE—$57.57
FL—$57.57
GA—$57.57
HI$59.18—
IA—$57.57
ID—$57.57
IL—$57.57
IN—$57.57
KS—$57.57
KY—$57.57
LA—$57.57
MA—$57.57
MD—$57.57
ME—$57.57
MI—$57.57
MN—$57.57
MO—$57.57
MS—$57.57
MT—$57.57
NC—$57.57
ND—$57.57
NE—$57.57
NH—$57.57
NJ—$57.57
NM—$57.57
NV—$57.57
NY—$57.57
OH—$57.57
OK—$57.57
OR—$57.57
PA—$57.57
PR$65.51—
RI—$57.57
SC—$57.57
SD—$57.57
TN—$57.57
TX—$57.57
UT—$57.57
VA—$57.57
VI$59.18—
VT—$57.57
WA—$57.57
WI—$57.57
WV—$57.57
WY—$57.57

RR + KU — Monthly rental Capped rental

Medicare allowable ranges from $55.28 to $66.31 depending on state and rural status.

Former-CBA payment limits: ceiling $55.28 · floor $46.99

StateNon-ruralRural
AK$55.28—
AL$55.28—
AR$55.28—
AZ$55.28—
CA$55.28—
CO$55.28—
CT$55.28—
DC$55.28—
DE$55.28—
FL$55.28—
GA$55.28—
HI$55.28—
IA$55.28—
ID$55.28—
IL$55.28—
IN$55.28—
KS$55.28—
KY$55.28—
LA$55.28—
MA$55.28—
MD$55.28—
ME$55.28—
MI$55.28—
MN$55.28—
MO$55.28—
MS$55.28—
MT$55.28—
NC$55.28—
ND$55.28—
NE$55.28—
NH$55.28—
NJ$55.28—
NM$55.28—
NV$55.28—
NY$55.28—
OH$55.28—
OK$55.28—
OR$55.28—
PA$55.28—
PR$66.31—
RI$55.28—
SC$55.28—
SD$55.28—
TN$55.28—
TX$55.28—
UT$55.28—
VA$55.28—
VI$55.28—
VT$55.28—
WA$55.28—
WI$55.28—
WV$55.28—
WY$55.28—
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 E2369 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

CO-50 medical necessityCO-151 frequency/units

Related E-codes

E2301E2310E2311E2312E2313E2321E2322E2323E2324E2325E2326E2327

Bill E2369 with confidence

Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, E2369 included, and starter credits via POST /bot-marketplace/register.