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E2388 — Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each

HCPCS Level II E-code · short descriptor: “Foam 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
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.

E2388 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $59.52 to $63.80 depending on state and rural status.

StateNon-ruralRural
AK$60.70
AL$59.52$60.70
AR$59.52$60.70
AZ$59.52$60.70
CA$59.52$60.70
CO$59.52$60.70
CT$59.52$60.70
DC$59.52$60.70
DE$59.52$60.70
FL$59.52$60.70
GA$59.52$60.70
HI$60.70
IA$59.52$60.70
ID$59.52$60.70
IL$59.52$60.70
IN$59.52$60.70
KS$59.52$60.70
KY$59.52$60.70
LA$59.52$60.70
MA$59.52$60.70
MD$59.52$60.70
ME$59.52$60.70
MI$59.52$60.70
MN$59.52$60.70
MO$59.52$60.70
MS$59.52$60.70
MT$59.52$60.70
NC$59.52$60.70
ND$59.52$60.70
NE$59.52$60.70
NH$59.52$60.70
NJ$59.52$60.70
NM$59.52$60.70
NV$59.52$60.70
NY$59.52$60.70
OH$59.52$60.70
OK$59.52$60.70
OR$59.52$60.70
PA$59.52$60.70
PR$63.80
RI$59.52$60.70
SC$59.52$60.70
SD$59.52$60.70
TN$59.52$60.70
TX$59.52$60.70
UT$59.52$60.70
VA$59.52$60.70
VI$60.70
VT$59.52$60.70
WA$59.52$60.70
WI$59.52$60.70
WV$59.52$60.70
WY$59.52$60.70

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $65.18 to $68.74 depending on state and rural status.

StateNon-ruralRural
AK$65.18
AL$65.18
AR$65.18
AZ$65.18
CA$65.18
CO$65.18
CT$65.18
DC$65.18
DE$65.18
FL$65.18
GA$65.18
HI$65.18
IA$65.18
ID$65.18
IL$65.18
IN$65.18
KS$65.18
KY$65.18
LA$65.18
MA$65.18
MD$65.18
ME$65.18
MI$65.18
MN$65.18
MO$65.18
MS$65.18
MT$65.18
NC$65.18
ND$65.18
NE$65.18
NH$65.18
NJ$65.18
NM$65.18
NV$65.18
NY$65.18
OH$65.18
OK$65.18
OR$65.18
PA$65.18
PR$68.74
RI$65.18
SC$65.18
SD$65.18
TN$65.18
TX$65.18
UT$65.18
VA$65.18
VI$65.18
VT$65.18
WA$65.18
WI$65.18
WV$65.18
WY$65.18

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $61.87 to $68.12 depending on state and rural status.

Former-CBA payment limits: ceiling $61.87 · floor $52.59

StateNon-ruralRural
AK$61.87
AL$61.87
AR$61.87
AZ$61.87
CA$61.87
CO$61.87
CT$61.87
DC$61.87
DE$61.87
FL$61.87
GA$61.87
HI$61.87
IA$61.87
ID$61.87
IL$61.87
IN$61.87
KS$61.87
KY$61.87
LA$61.87
MA$61.87
MD$61.87
ME$61.87
MI$61.87
MN$61.87
MO$61.87
MS$61.87
MT$61.87
NC$61.87
ND$61.87
NE$61.87
NH$61.87
NJ$61.87
NM$61.87
NV$61.87
NY$61.87
OH$61.87
OK$61.87
OR$61.87
PA$61.87
PR$68.12
RI$61.87
SC$61.87
SD$61.87
TN$61.87
TX$61.87
UT$61.87
VA$61.87
VI$61.87
VT$61.87
WA$61.87
WI$61.87
WV$61.87
WY$61.87

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $5.95 to $6.37 depending on state and rural status.

StateNon-ruralRural
AK$6.08
AL$5.95$6.08
AR$5.95$6.08
AZ$5.95$6.08
CA$5.95$6.08
CO$5.95$6.08
CT$5.95$6.08
DC$5.95$6.08
DE$5.95$6.08
FL$5.95$6.08
GA$5.95$6.08
HI$6.08
IA$5.95$6.08
ID$5.95$6.08
IL$5.95$6.08
IN$5.95$6.08
KS$5.95$6.08
KY$5.95$6.08
LA$5.95$6.08
MA$5.95$6.08
MD$5.95$6.08
ME$5.95$6.08
MI$5.95$6.08
MN$5.95$6.08
MO$5.95$6.08
MS$5.95$6.08
MT$5.95$6.08
NC$5.95$6.08
ND$5.95$6.08
NE$5.95$6.08
NH$5.95$6.08
NJ$5.95$6.08
NM$5.95$6.08
NV$5.95$6.08
NY$5.95$6.08
OH$5.95$6.08
OK$5.95$6.08
OR$5.95$6.08
PA$5.95$6.08
PR$6.37
RI$5.95$6.08
SC$5.95$6.08
SD$5.95$6.08
TN$5.95$6.08
TX$5.95$6.08
UT$5.95$6.08
VA$5.95$6.08
VI$6.08
VT$5.95$6.08
WA$5.95$6.08
WI$5.95$6.08
WV$5.95$6.08
WY$5.95$6.08

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.53 to $6.86 depending on state and rural status.

StateNon-ruralRural
AK$6.53
AL$6.53
AR$6.53
AZ$6.53
CA$6.53
CO$6.53
CT$6.53
DC$6.53
DE$6.53
FL$6.53
GA$6.53
HI$6.53
IA$6.53
ID$6.53
IL$6.53
IN$6.53
KS$6.53
KY$6.53
LA$6.53
MA$6.53
MD$6.53
ME$6.53
MI$6.53
MN$6.53
MO$6.53
MS$6.53
MT$6.53
NC$6.53
ND$6.53
NE$6.53
NH$6.53
NJ$6.53
NM$6.53
NV$6.53
NY$6.53
OH$6.53
OK$6.53
OR$6.53
PA$6.53
PR$6.86
RI$6.53
SC$6.53
SD$6.53
TN$6.53
TX$6.53
UT$6.53
VA$6.53
VI$6.53
VT$6.53
WA$6.53
WI$6.53
WV$6.53
WY$6.53

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.19 to $6.79 depending on state and rural status.

Former-CBA payment limits: ceiling $6.19 · floor $5.26

StateNon-ruralRural
AK$6.19
AL$6.19
AR$6.19
AZ$6.19
CA$6.19
CO$6.19
CT$6.19
DC$6.19
DE$6.19
FL$6.19
GA$6.19
HI$6.19
IA$6.19
ID$6.19
IL$6.19
IN$6.19
KS$6.19
KY$6.19
LA$6.19
MA$6.19
MD$6.19
ME$6.19
MI$6.19
MN$6.19
MO$6.19
MS$6.19
MT$6.19
NC$6.19
ND$6.19
NE$6.19
NH$6.19
NJ$6.19
NM$6.19
NV$6.19
NY$6.19
OH$6.19
OK$6.19
OR$6.19
PA$6.19
PR$6.79
RI$6.19
SC$6.19
SD$6.19
TN$6.19
TX$6.19
UT$6.19
VA$6.19
VI$6.19
VT$6.19
WA$6.19
WI$6.19
WV$6.19
WY$6.19

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $44.64 to $47.85 depending on state and rural status.

StateNon-ruralRural
AK$45.53
AL$44.64$45.53
AR$44.64$45.53
AZ$44.64$45.53
CA$44.64$45.53
CO$44.64$45.53
CT$44.64$45.53
DC$44.64$45.53
DE$44.64$45.53
FL$44.64$45.53
GA$44.64$45.53
HI$45.53
IA$44.64$45.53
ID$44.64$45.53
IL$44.64$45.53
IN$44.64$45.53
KS$44.64$45.53
KY$44.64$45.53
LA$44.64$45.53
MA$44.64$45.53
MD$44.64$45.53
ME$44.64$45.53
MI$44.64$45.53
MN$44.64$45.53
MO$44.64$45.53
MS$44.64$45.53
MT$44.64$45.53
NC$44.64$45.53
ND$44.64$45.53
NE$44.64$45.53
NH$44.64$45.53
NJ$44.64$45.53
NM$44.64$45.53
NV$44.64$45.53
NY$44.64$45.53
OH$44.64$45.53
OK$44.64$45.53
OR$44.64$45.53
PA$44.64$45.53
PR$47.85
RI$44.64$45.53
SC$44.64$45.53
SD$44.64$45.53
TN$44.64$45.53
TX$44.64$45.53
UT$44.64$45.53
VA$44.64$45.53
VI$45.53
VT$44.64$45.53
WA$44.64$45.53
WI$44.64$45.53
WV$44.64$45.53
WY$44.64$45.53

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $48.90 to $51.55 depending on state and rural status.

StateNon-ruralRural
AK$48.90
AL$48.90
AR$48.90
AZ$48.90
CA$48.90
CO$48.90
CT$48.90
DC$48.90
DE$48.90
FL$48.90
GA$48.90
HI$48.90
IA$48.90
ID$48.90
IL$48.90
IN$48.90
KS$48.90
KY$48.90
LA$48.90
MA$48.90
MD$48.90
ME$48.90
MI$48.90
MN$48.90
MO$48.90
MS$48.90
MT$48.90
NC$48.90
ND$48.90
NE$48.90
NH$48.90
NJ$48.90
NM$48.90
NV$48.90
NY$48.90
OH$48.90
OK$48.90
OR$48.90
PA$48.90
PR$51.55
RI$48.90
SC$48.90
SD$48.90
TN$48.90
TX$48.90
UT$48.90
VA$48.90
VI$48.90
VT$48.90
WA$48.90
WI$48.90
WV$48.90
WY$48.90

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $46.44 to $51.06 depending on state and rural status.

Former-CBA payment limits: ceiling $46.44 · floor $39.47

StateNon-ruralRural
AK$46.44
AL$46.44
AR$46.44
AZ$46.44
CA$46.44
CO$46.44
CT$46.44
DC$46.44
DE$46.44
FL$46.44
GA$46.44
HI$46.44
IA$46.44
ID$46.44
IL$46.44
IN$46.44
KS$46.44
KY$46.44
LA$46.44
MA$46.44
MD$46.44
ME$46.44
MI$46.44
MN$46.44
MO$46.44
MS$46.44
MT$46.44
NC$46.44
ND$46.44
NE$46.44
NH$46.44
NJ$46.44
NM$46.44
NV$46.44
NY$46.44
OH$46.44
OK$46.44
OR$46.44
PA$46.44
PR$51.06
RI$46.44
SC$46.44
SD$46.44
TN$46.44
TX$46.44
UT$46.44
VA$46.44
VI$46.44
VT$46.44
WA$46.44
WI$46.44
WV$46.44
WY$46.44
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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