E2381 — Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each
HCPCS Level II E-code · short descriptor: “Pneum drive wheel tire”
- 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
- 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.
E2381 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $69.40 to $101.61 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $91.46 | — |
| AL | $73.56 | $87.53 |
| AR | $73.56 | $87.53 |
| AZ | $71.89 | $86.75 |
| CA | $69.40 | $86.75 |
| CO | $75.28 | $87.53 |
| CT | $75.04 | $87.53 |
| DC | $74.59 | $87.53 |
| DE | $74.59 | $87.53 |
| FL | $73.56 | $87.53 |
| GA | $73.56 | $87.53 |
| HI | $91.46 | — |
| IA | $72.83 | $86.75 |
| ID | $75.28 | $86.75 |
| IL | $79.71 | $87.53 |
| IN | $79.71 | $87.53 |
| KS | $72.83 | $86.75 |
| KY | $73.56 | $87.53 |
| LA | $73.56 | $87.53 |
| MA | $75.04 | $87.53 |
| MD | $74.59 | $87.53 |
| ME | $75.04 | $87.53 |
| MI | $79.71 | $87.53 |
| MN | $72.83 | $87.53 |
| MO | $72.83 | $87.53 |
| MS | $73.56 | $87.53 |
| MT | $75.28 | $86.75 |
| NC | $73.56 | $87.53 |
| ND | $72.83 | $86.75 |
| NE | $72.83 | $86.75 |
| NH | $75.04 | $87.53 |
| NJ | $74.59 | $87.53 |
| NM | $71.89 | $87.53 |
| NV | $69.40 | $86.75 |
| NY | $74.59 | $87.53 |
| OH | $79.71 | $87.53 |
| OK | $71.89 | $87.53 |
| OR | $69.40 | $86.75 |
| PA | $74.59 | $87.53 |
| PR | $101.61 | — |
| RI | $75.04 | $87.53 |
| SC | $73.56 | $87.53 |
| SD | $72.83 | $86.75 |
| TN | $73.56 | $87.53 |
| TX | $71.89 | $87.53 |
| UT | $75.28 | $87.53 |
| VA | $73.56 | $87.53 |
| VI | $92.24 | — |
| VT | $75.04 | $87.53 |
| WA | $69.40 | $86.75 |
| WI | $79.71 | $87.53 |
| WV | $73.56 | $87.53 |
| WY | $75.28 | $86.75 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $93.42 to $109.75 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $98.13 | — |
| AL | — | $94.31 |
| AR | — | $94.31 |
| AZ | — | $93.42 |
| CA | — | $93.42 |
| CO | — | $94.31 |
| CT | — | $94.31 |
| DC | — | $94.31 |
| DE | — | $94.31 |
| FL | — | $94.31 |
| GA | — | $94.31 |
| HI | $98.13 | — |
| IA | — | $93.42 |
| ID | — | $93.42 |
| IL | — | $94.31 |
| IN | — | $94.31 |
| KS | — | $93.42 |
| KY | — | $94.31 |
| LA | — | $94.31 |
| MA | — | $94.31 |
| MD | — | $94.31 |
| ME | — | $94.31 |
| MI | — | $94.31 |
| MN | — | $94.31 |
| MO | — | $94.31 |
| MS | — | $94.31 |
| MT | — | $93.42 |
| NC | — | $94.31 |
| ND | — | $93.42 |
| NE | — | $93.42 |
| NH | — | $94.31 |
| NJ | — | $94.31 |
| NM | — | $94.31 |
| NV | — | $93.42 |
| NY | — | $94.31 |
| OH | — | $94.31 |
| OK | — | $94.31 |
| OR | — | $93.42 |
| PA | — | $94.31 |
| PR | $109.75 | — |
| RI | — | $94.31 |
| SC | — | $94.31 |
| SD | — | $93.42 |
| TN | — | $94.31 |
| TX | — | $94.31 |
| UT | — | $94.31 |
| VA | — | $94.31 |
| VI | $99.02 | — |
| VT | — | $94.31 |
| WA | — | $93.42 |
| WI | — | $94.31 |
| WV | — | $94.31 |
| WY | — | $93.42 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $91.98 to $112.29 depending on state and rural status.
Former-CBA payment limits: ceiling $93.56 · floor $79.53
| State | Non-rural | Rural |
|---|---|---|
| AK | $91.98 | — |
| AL | $93.56 | — |
| AR | $93.56 | — |
| AZ | $91.98 | — |
| CA | $91.98 | — |
| CO | $93.56 | — |
| CT | $93.56 | — |
| DC | $93.56 | — |
| DE | $93.56 | — |
| FL | $93.56 | — |
| GA | $93.56 | — |
| HI | $91.98 | — |
| IA | $91.98 | — |
| ID | $91.98 | — |
| IL | $93.56 | — |
| IN | $93.56 | — |
| KS | $91.98 | — |
| KY | $93.56 | — |
| LA | $93.56 | — |
| MA | $93.56 | — |
| MD | $93.56 | — |
| ME | $93.56 | — |
| MI | $93.56 | — |
| MN | $93.56 | — |
| MO | $93.56 | — |
| MS | $93.56 | — |
| MT | $91.98 | — |
| NC | $93.56 | — |
| ND | $91.98 | — |
| NE | $91.98 | — |
| NH | $93.56 | — |
| NJ | $93.56 | — |
| NM | $93.56 | — |
| NV | $91.98 | — |
| NY | $93.56 | — |
| OH | $93.56 | — |
| OK | $93.56 | — |
| OR | $91.98 | — |
| PA | $93.56 | — |
| PR | $112.29 | — |
| RI | $93.56 | — |
| SC | $93.56 | — |
| SD | $91.98 | — |
| TN | $93.56 | — |
| TX | $93.56 | — |
| UT | $93.56 | — |
| VA | $93.56 | — |
| VI | $93.56 | — |
| VT | $93.56 | — |
| WA | $91.98 | — |
| WI | $93.56 | — |
| WV | $93.56 | — |
| WY | $91.98 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.94 to $10.17 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $9.14 | — |
| AL | $7.36 | $8.77 |
| AR | $7.36 | $8.77 |
| AZ | $7.19 | $8.67 |
| CA | $6.94 | $8.67 |
| CO | $7.53 | $8.77 |
| CT | $7.50 | $8.77 |
| DC | $7.46 | $8.77 |
| DE | $7.46 | $8.77 |
| FL | $7.36 | $8.77 |
| GA | $7.36 | $8.77 |
| HI | $9.14 | — |
| IA | $7.28 | $8.67 |
| ID | $7.53 | $8.67 |
| IL | $7.97 | $8.77 |
| IN | $7.97 | $8.77 |
| KS | $7.28 | $8.67 |
| KY | $7.36 | $8.77 |
| LA | $7.36 | $8.77 |
| MA | $7.50 | $8.77 |
| MD | $7.46 | $8.77 |
| ME | $7.50 | $8.77 |
| MI | $7.97 | $8.77 |
| MN | $7.28 | $8.77 |
| MO | $7.28 | $8.77 |
| MS | $7.36 | $8.77 |
| MT | $7.53 | $8.67 |
| NC | $7.36 | $8.77 |
| ND | $7.28 | $8.67 |
| NE | $7.28 | $8.67 |
| NH | $7.50 | $8.77 |
| NJ | $7.46 | $8.77 |
| NM | $7.19 | $8.77 |
| NV | $6.94 | $8.67 |
| NY | $7.46 | $8.77 |
| OH | $7.97 | $8.77 |
| OK | $7.19 | $8.77 |
| OR | $6.94 | $8.67 |
| PA | $7.46 | $8.77 |
| PR | $10.17 | — |
| RI | $7.50 | $8.77 |
| SC | $7.36 | $8.77 |
| SD | $7.28 | $8.67 |
| TN | $7.36 | $8.77 |
| TX | $7.19 | $8.77 |
| UT | $7.53 | $8.77 |
| VA | $7.36 | $8.77 |
| VI | $9.24 | — |
| VT | $7.50 | $8.77 |
| WA | $6.94 | $8.67 |
| WI | $7.97 | $8.77 |
| WV | $7.36 | $8.77 |
| WY | $7.53 | $8.67 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $9.33 to $10.99 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $9.80 | — |
| AL | — | $9.45 |
| AR | — | $9.45 |
| AZ | — | $9.33 |
| CA | — | $9.33 |
| CO | — | $9.45 |
| CT | — | $9.45 |
| DC | — | $9.45 |
| DE | — | $9.45 |
| FL | — | $9.45 |
| GA | — | $9.45 |
| HI | $9.80 | — |
| IA | — | $9.33 |
| ID | — | $9.33 |
| IL | — | $9.45 |
| IN | — | $9.45 |
| KS | — | $9.33 |
| KY | — | $9.45 |
| LA | — | $9.45 |
| MA | — | $9.45 |
| MD | — | $9.45 |
| ME | — | $9.45 |
| MI | — | $9.45 |
| MN | — | $9.45 |
| MO | — | $9.45 |
| MS | — | $9.45 |
| MT | — | $9.33 |
| NC | — | $9.45 |
| ND | — | $9.33 |
| NE | — | $9.33 |
| NH | — | $9.45 |
| NJ | — | $9.45 |
| NM | — | $9.45 |
| NV | — | $9.33 |
| NY | — | $9.45 |
| OH | — | $9.45 |
| OK | — | $9.45 |
| OR | — | $9.33 |
| PA | — | $9.45 |
| PR | $10.99 | — |
| RI | — | $9.45 |
| SC | — | $9.45 |
| SD | — | $9.33 |
| TN | — | $9.45 |
| TX | — | $9.45 |
| UT | — | $9.45 |
| VA | — | $9.45 |
| VI | $9.92 | — |
| VT | — | $9.45 |
| WA | — | $9.33 |
| WI | — | $9.45 |
| WV | — | $9.45 |
| WY | — | $9.33 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $9.18 to $11.24 depending on state and rural status.
Former-CBA payment limits: ceiling $9.39 · floor $7.98
| State | Non-rural | Rural |
|---|---|---|
| AK | $9.18 | — |
| AL | $9.39 | — |
| AR | $9.39 | — |
| AZ | $9.18 | — |
| CA | $9.18 | — |
| CO | $9.39 | — |
| CT | $9.39 | — |
| DC | $9.39 | — |
| DE | $9.39 | — |
| FL | $9.39 | — |
| GA | $9.39 | — |
| HI | $9.18 | — |
| IA | $9.18 | — |
| ID | $9.18 | — |
| IL | $9.39 | — |
| IN | $9.39 | — |
| KS | $9.18 | — |
| KY | $9.39 | — |
| LA | $9.39 | — |
| MA | $9.39 | — |
| MD | $9.39 | — |
| ME | $9.39 | — |
| MI | $9.39 | — |
| MN | $9.39 | — |
| MO | $9.39 | — |
| MS | $9.39 | — |
| MT | $9.18 | — |
| NC | $9.39 | — |
| ND | $9.18 | — |
| NE | $9.18 | — |
| NH | $9.39 | — |
| NJ | $9.39 | — |
| NM | $9.39 | — |
| NV | $9.18 | — |
| NY | $9.39 | — |
| OH | $9.39 | — |
| OK | $9.39 | — |
| OR | $9.18 | — |
| PA | $9.39 | — |
| PR | $11.24 | — |
| RI | $9.39 | — |
| SC | $9.39 | — |
| SD | $9.18 | — |
| TN | $9.39 | — |
| TX | $9.39 | — |
| UT | $9.39 | — |
| VA | $9.39 | — |
| VI | $9.39 | — |
| VT | $9.39 | — |
| WA | $9.18 | — |
| WI | $9.39 | — |
| WV | $9.39 | — |
| WY | $9.18 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $52.05 to $76.22 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $68.60 | — |
| AL | $55.17 | $65.65 |
| AR | $55.17 | $65.65 |
| AZ | $53.92 | $65.06 |
| CA | $52.05 | $65.06 |
| CO | $56.46 | $65.65 |
| CT | $56.28 | $65.65 |
| DC | $55.95 | $65.65 |
| DE | $55.95 | $65.65 |
| FL | $55.17 | $65.65 |
| GA | $55.17 | $65.65 |
| HI | $68.60 | — |
| IA | $54.62 | $65.06 |
| ID | $56.46 | $65.06 |
| IL | $59.78 | $65.65 |
| IN | $59.78 | $65.65 |
| KS | $54.62 | $65.06 |
| KY | $55.17 | $65.65 |
| LA | $55.17 | $65.65 |
| MA | $56.28 | $65.65 |
| MD | $55.95 | $65.65 |
| ME | $56.28 | $65.65 |
| MI | $59.78 | $65.65 |
| MN | $54.62 | $65.65 |
| MO | $54.62 | $65.65 |
| MS | $55.17 | $65.65 |
| MT | $56.46 | $65.06 |
| NC | $55.17 | $65.65 |
| ND | $54.62 | $65.06 |
| NE | $54.62 | $65.06 |
| NH | $56.28 | $65.65 |
| NJ | $55.95 | $65.65 |
| NM | $53.92 | $65.65 |
| NV | $52.05 | $65.06 |
| NY | $55.95 | $65.65 |
| OH | $59.78 | $65.65 |
| OK | $53.92 | $65.65 |
| OR | $52.05 | $65.06 |
| PA | $55.95 | $65.65 |
| PR | $76.22 | — |
| RI | $56.28 | $65.65 |
| SC | $55.17 | $65.65 |
| SD | $54.62 | $65.06 |
| TN | $55.17 | $65.65 |
| TX | $53.92 | $65.65 |
| UT | $56.46 | $65.65 |
| VA | $55.17 | $65.65 |
| VI | $69.19 | — |
| VT | $56.28 | $65.65 |
| WA | $52.05 | $65.06 |
| WI | $59.78 | $65.65 |
| WV | $55.17 | $65.65 |
| WY | $56.46 | $65.06 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $70.07 to $82.33 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $73.60 | — |
| AL | — | $70.74 |
| AR | — | $70.74 |
| AZ | — | $70.07 |
| CA | — | $70.07 |
| CO | — | $70.74 |
| CT | — | $70.74 |
| DC | — | $70.74 |
| DE | — | $70.74 |
| FL | — | $70.74 |
| GA | — | $70.74 |
| HI | $73.60 | — |
| IA | — | $70.07 |
| ID | — | $70.07 |
| IL | — | $70.74 |
| IN | — | $70.74 |
| KS | — | $70.07 |
| KY | — | $70.74 |
| LA | — | $70.74 |
| MA | — | $70.74 |
| MD | — | $70.74 |
| ME | — | $70.74 |
| MI | — | $70.74 |
| MN | — | $70.74 |
| MO | — | $70.74 |
| MS | — | $70.74 |
| MT | — | $70.07 |
| NC | — | $70.74 |
| ND | — | $70.07 |
| NE | — | $70.07 |
| NH | — | $70.74 |
| NJ | — | $70.74 |
| NM | — | $70.74 |
| NV | — | $70.07 |
| NY | — | $70.74 |
| OH | — | $70.74 |
| OK | — | $70.74 |
| OR | — | $70.07 |
| PA | — | $70.74 |
| PR | $82.33 | — |
| RI | — | $70.74 |
| SC | — | $70.74 |
| SD | — | $70.07 |
| TN | — | $70.74 |
| TX | — | $70.74 |
| UT | — | $70.74 |
| VA | — | $70.74 |
| VI | $74.27 | — |
| VT | — | $70.74 |
| WA | — | $70.07 |
| WI | — | $70.74 |
| WV | — | $70.74 |
| WY | — | $70.07 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $68.97 to $84.25 depending on state and rural status.
Former-CBA payment limits: ceiling $70.16 · floor $59.64
| State | Non-rural | Rural |
|---|---|---|
| AK | $68.97 | — |
| AL | $70.16 | — |
| AR | $70.16 | — |
| AZ | $68.97 | — |
| CA | $68.97 | — |
| CO | $70.16 | — |
| CT | $70.16 | — |
| DC | $70.16 | — |
| DE | $70.16 | — |
| FL | $70.16 | — |
| GA | $70.16 | — |
| HI | $68.97 | — |
| IA | $68.97 | — |
| ID | $68.97 | — |
| IL | $70.16 | — |
| IN | $70.16 | — |
| KS | $68.97 | — |
| 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 | $68.97 | — |
| NC | $70.16 | — |
| ND | $68.97 | — |
| NE | $68.97 | — |
| NH | $70.16 | — |
| NJ | $70.16 | — |
| NM | $70.16 | — |
| NV | $68.97 | — |
| NY | $70.16 | — |
| OH | $70.16 | — |
| OK | $70.16 | — |
| OR | $68.97 | — |
| PA | $70.16 | — |
| PR | $84.25 | — |
| RI | $70.16 | — |
| SC | $70.16 | — |
| SD | $68.97 | — |
| TN | $70.16 | — |
| TX | $70.16 | — |
| UT | $70.16 | — |
| VA | $70.16 | — |
| VI | $70.16 | — |
| VT | $70.16 | — |
| WA | $68.97 | — |
| WI | $70.16 | — |
| WV | $70.16 | — |
| WY | $68.97 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2381 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
Related E-codes
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