MyMedi-AI

E2391 — Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each

HCPCS Level II E-code · short descriptor: “Solid caster 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
4
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.

E2391 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $20.63 to $26.03 depending on state and rural status.

StateNon-ruralRural
AK$24.75—
AL$21.21$24.39
AR$21.21$24.39
AZ$20.98$24.39
CA$20.63$24.39
CO$21.71$24.39
CT$22.62$24.39
DC$20.83$24.39
DE$20.83$24.39
FL$21.21$24.39
GA$21.21$24.39
HI$24.75—
IA$21.04$24.39
ID$21.71$24.39
IL$22.90$24.39
IN$22.90$24.39
KS$21.04$24.39
KY$21.21$24.39
LA$21.21$24.39
MA$22.62$24.39
MD$20.83$24.39
ME$22.62$24.39
MI$22.90$24.39
MN$21.04$24.39
MO$21.04$24.39
MS$21.21$24.39
MT$21.71$24.39
NC$21.21$24.39
ND$21.04$24.39
NE$21.04$24.39
NH$22.62$24.39
NJ$20.83$24.39
NM$20.98$24.39
NV$20.63$24.39
NY$20.83$24.39
OH$22.90$24.39
OK$20.98$24.39
OR$20.63$24.39
PA$20.83$24.39
PR$26.03—
RI$22.62$24.39
SC$21.21$24.39
SD$21.04$24.39
TN$21.21$24.39
TX$20.98$24.39
UT$21.71$24.39
VA$21.21$24.39
VI$24.75—
VT$22.62$24.39
WA$20.63$24.39
WI$22.90$24.39
WV$21.21$24.39
WY$21.71$24.39

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $26.22 to $28.04 depending on state and rural status.

StateNon-ruralRural
AK$26.57—
AL—$26.22
AR—$26.22
AZ—$26.22
CA—$26.22
CO—$26.22
CT—$26.22
DC—$26.22
DE—$26.22
FL—$26.22
GA—$26.22
HI$26.57—
IA—$26.22
ID—$26.22
IL—$26.22
IN—$26.22
KS—$26.22
KY—$26.22
LA—$26.22
MA—$26.22
MD—$26.22
ME—$26.22
MI—$26.22
MN—$26.22
MO—$26.22
MS—$26.22
MT—$26.22
NC—$26.22
ND—$26.22
NE—$26.22
NH—$26.22
NJ—$26.22
NM—$26.22
NV—$26.22
NY—$26.22
OH—$26.22
OK—$26.22
OR—$26.22
PA—$26.22
PR$28.04—
RI—$26.22
SC—$26.22
SD—$26.22
TN—$26.22
TX—$26.22
UT—$26.22
VA—$26.22
VI$26.57—
VT—$26.22
WA—$26.22
WI—$26.22
WV—$26.22
WY—$26.22

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $25.17 to $27.73 depending on state and rural status.

Former-CBA payment limits: ceiling $25.17 · floor $21.39

StateNon-ruralRural
AK$25.17—
AL$25.17—
AR$25.17—
AZ$25.17—
CA$25.17—
CO$25.17—
CT$25.17—
DC$25.17—
DE$25.17—
FL$25.17—
GA$25.17—
HI$25.17—
IA$25.17—
ID$25.17—
IL$25.17—
IN$25.17—
KS$25.17—
KY$25.17—
LA$25.17—
MA$25.17—
MD$25.17—
ME$25.17—
MI$25.17—
MN$25.17—
MO$25.17—
MS$25.17—
MT$25.17—
NC$25.17—
ND$25.17—
NE$25.17—
NH$25.17—
NJ$25.17—
NM$25.17—
NV$25.17—
NY$25.17—
OH$25.17—
OK$25.17—
OR$25.17—
PA$25.17—
PR$27.73—
RI$25.17—
SC$25.17—
SD$25.17—
TN$25.17—
TX$25.17—
UT$25.17—
VA$25.17—
VI$25.17—
VT$25.17—
WA$25.17—
WI$25.17—
WV$25.17—
WY$25.17—

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $2.06 to $2.61 depending on state and rural status.

StateNon-ruralRural
AK$2.48—
AL$2.12$2.45
AR$2.12$2.45
AZ$2.10$2.45
CA$2.06$2.45
CO$2.17$2.45
CT$2.26$2.45
DC$2.08$2.45
DE$2.08$2.45
FL$2.12$2.45
GA$2.12$2.45
HI$2.48—
IA$2.10$2.45
ID$2.17$2.45
IL$2.29$2.45
IN$2.29$2.45
KS$2.10$2.45
KY$2.12$2.45
LA$2.12$2.45
MA$2.26$2.45
MD$2.08$2.45
ME$2.26$2.45
MI$2.29$2.45
MN$2.10$2.45
MO$2.10$2.45
MS$2.12$2.45
MT$2.17$2.45
NC$2.12$2.45
ND$2.10$2.45
NE$2.10$2.45
NH$2.26$2.45
NJ$2.08$2.45
NM$2.10$2.45
NV$2.06$2.45
NY$2.08$2.45
OH$2.29$2.45
OK$2.10$2.45
OR$2.06$2.45
PA$2.08$2.45
PR$2.61—
RI$2.26$2.45
SC$2.12$2.45
SD$2.10$2.45
TN$2.12$2.45
TX$2.10$2.45
UT$2.17$2.45
VA$2.12$2.45
VI$2.48—
VT$2.26$2.45
WA$2.06$2.45
WI$2.29$2.45
WV$2.12$2.45
WY$2.17$2.45

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $2.63 to $2.81 depending on state and rural status.

StateNon-ruralRural
AK$2.66—
AL—$2.63
AR—$2.63
AZ—$2.63
CA—$2.63
CO—$2.63
CT—$2.63
DC—$2.63
DE—$2.63
FL—$2.63
GA—$2.63
HI$2.66—
IA—$2.63
ID—$2.63
IL—$2.63
IN—$2.63
KS—$2.63
KY—$2.63
LA—$2.63
MA—$2.63
MD—$2.63
ME—$2.63
MI—$2.63
MN—$2.63
MO—$2.63
MS—$2.63
MT—$2.63
NC—$2.63
ND—$2.63
NE—$2.63
NH—$2.63
NJ—$2.63
NM—$2.63
NV—$2.63
NY—$2.63
OH—$2.63
OK—$2.63
OR—$2.63
PA—$2.63
PR$2.81—
RI—$2.63
SC—$2.63
SD—$2.63
TN—$2.63
TX—$2.63
UT—$2.63
VA—$2.63
VI$2.66—
VT—$2.63
WA—$2.63
WI—$2.63
WV—$2.63
WY—$2.63

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $2.53 to $2.78 depending on state and rural status.

Former-CBA payment limits: ceiling $2.53 · floor $2.15

StateNon-ruralRural
AK$2.53—
AL$2.53—
AR$2.53—
AZ$2.53—
CA$2.53—
CO$2.53—
CT$2.53—
DC$2.53—
DE$2.53—
FL$2.53—
GA$2.53—
HI$2.53—
IA$2.53—
ID$2.53—
IL$2.53—
IN$2.53—
KS$2.53—
KY$2.53—
LA$2.53—
MA$2.53—
MD$2.53—
ME$2.53—
MI$2.53—
MN$2.53—
MO$2.53—
MS$2.53—
MT$2.53—
NC$2.53—
ND$2.53—
NE$2.53—
NH$2.53—
NJ$2.53—
NM$2.53—
NV$2.53—
NY$2.53—
OH$2.53—
OK$2.53—
OR$2.53—
PA$2.53—
PR$2.78—
RI$2.53—
SC$2.53—
SD$2.53—
TN$2.53—
TX$2.53—
UT$2.53—
VA$2.53—
VI$2.53—
VT$2.53—
WA$2.53—
WI$2.53—
WV$2.53—
WY$2.53—

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $15.47 to $19.51 depending on state and rural status.

StateNon-ruralRural
AK$18.57—
AL$15.91$18.30
AR$15.91$18.30
AZ$15.74$18.30
CA$15.47$18.30
CO$16.28$18.30
CT$16.97$18.30
DC$15.62$18.30
DE$15.62$18.30
FL$15.91$18.30
GA$15.91$18.30
HI$18.57—
IA$15.78$18.30
ID$16.28$18.30
IL$17.18$18.30
IN$17.18$18.30
KS$15.78$18.30
KY$15.91$18.30
LA$15.91$18.30
MA$16.97$18.30
MD$15.62$18.30
ME$16.97$18.30
MI$17.18$18.30
MN$15.78$18.30
MO$15.78$18.30
MS$15.91$18.30
MT$16.28$18.30
NC$15.91$18.30
ND$15.78$18.30
NE$15.78$18.30
NH$16.97$18.30
NJ$15.62$18.30
NM$15.74$18.30
NV$15.47$18.30
NY$15.62$18.30
OH$17.18$18.30
OK$15.74$18.30
OR$15.47$18.30
PA$15.62$18.30
PR$19.51—
RI$16.97$18.30
SC$15.91$18.30
SD$15.78$18.30
TN$15.91$18.30
TX$15.74$18.30
UT$16.28$18.30
VA$15.91$18.30
VI$18.57—
VT$16.97$18.30
WA$15.47$18.30
WI$17.18$18.30
WV$15.91$18.30
WY$16.28$18.30

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $19.67 to $21.02 depending on state and rural status.

StateNon-ruralRural
AK$19.94—
AL—$19.67
AR—$19.67
AZ—$19.67
CA—$19.67
CO—$19.67
CT—$19.67
DC—$19.67
DE—$19.67
FL—$19.67
GA—$19.67
HI$19.94—
IA—$19.67
ID—$19.67
IL—$19.67
IN—$19.67
KS—$19.67
KY—$19.67
LA—$19.67
MA—$19.67
MD—$19.67
ME—$19.67
MI—$19.67
MN—$19.67
MO—$19.67
MS—$19.67
MT—$19.67
NC—$19.67
ND—$19.67
NE—$19.67
NH—$19.67
NJ—$19.67
NM—$19.67
NV—$19.67
NY—$19.67
OH—$19.67
OK—$19.67
OR—$19.67
PA—$19.67
PR$21.02—
RI—$19.67
SC—$19.67
SD—$19.67
TN—$19.67
TX—$19.67
UT—$19.67
VA—$19.67
VI$19.94—
VT—$19.67
WA—$19.67
WI—$19.67
WV—$19.67
WY—$19.67

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $18.88 to $20.78 depending on state and rural status.

Former-CBA payment limits: ceiling $18.88 · floor $16.05

StateNon-ruralRural
AK$18.88—
AL$18.88—
AR$18.88—
AZ$18.88—
CA$18.88—
CO$18.88—
CT$18.88—
DC$18.88—
DE$18.88—
FL$18.88—
GA$18.88—
HI$18.88—
IA$18.88—
ID$18.88—
IL$18.88—
IN$18.88—
KS$18.88—
KY$18.88—
LA$18.88—
MA$18.88—
MD$18.88—
ME$18.88—
MI$18.88—
MN$18.88—
MO$18.88—
MS$18.88—
MT$18.88—
NC$18.88—
ND$18.88—
NE$18.88—
NH$18.88—
NJ$18.88—
NM$18.88—
NV$18.88—
NY$18.88—
OH$18.88—
OK$18.88—
OR$18.88—
PA$18.88—
PR$20.78—
RI$18.88—
SC$18.88—
SD$18.88—
TN$18.88—
TX$18.88—
UT$18.88—
VA$18.88—
VI$18.88—
VT$18.88—
WA$18.88—
WI$18.88—
WV$18.88—
WY$18.88—
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 E2391 at 4 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

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