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E2395 — Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each

HCPCS Level II E-code · short descriptor: “Caster wheel excludes 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.

E2395 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $48.71 to $73.50 depending on state and rural status.

StateNon-ruralRural
AK$66.79
AL$53.46$62.66
AR$53.46$62.66
AZ$52.73$62.66
CA$53.44$62.66
CO$54.74$62.66
CT$48.71$62.66
DC$49.01$62.66
DE$49.01$62.66
FL$53.46$62.66
GA$53.46$62.66
HI$66.79
IA$54.95$62.66
ID$54.74$62.66
IL$57.40$62.66
IN$57.40$62.66
KS$54.95$62.66
KY$53.46$62.66
LA$53.46$62.66
MA$48.71$62.66
MD$49.01$62.66
ME$48.71$62.66
MI$57.40$62.66
MN$54.95$62.66
MO$54.95$62.66
MS$53.46$62.66
MT$54.74$62.66
NC$53.46$62.66
ND$54.95$62.66
NE$54.95$62.66
NH$48.71$62.66
NJ$49.01$62.66
NM$52.73$62.66
NV$53.44$62.66
NY$49.01$62.66
OH$57.40$62.66
OK$52.73$62.66
OR$53.44$62.66
PA$49.01$62.66
PR$73.50
RI$48.71$62.66
SC$53.46$62.66
SD$54.95$62.66
TN$53.46$62.66
TX$52.73$62.66
UT$54.74$62.66
VA$53.46$62.66
VI$66.79
VT$48.71$62.66
WA$53.44$62.66
WI$57.40$62.66
WV$53.46$62.66
WY$54.74$62.66

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $67.52 to $79.32 depending on state and rural status.

StateNon-ruralRural
AK$71.65
AL$67.52
AR$67.52
AZ$67.52
CA$67.52
CO$67.52
CT$67.52
DC$67.52
DE$67.52
FL$67.52
GA$67.52
HI$71.65
IA$67.52
ID$67.52
IL$67.52
IN$67.52
KS$67.52
KY$67.52
LA$67.52
MA$67.52
MD$67.52
ME$67.52
MI$67.52
MN$67.52
MO$67.52
MS$67.52
MT$67.52
NC$67.52
ND$67.52
NE$67.52
NH$67.52
NJ$67.52
NM$67.52
NV$67.52
NY$67.52
OH$67.52
OK$67.52
OR$67.52
PA$67.52
PR$79.32
RI$67.52
SC$67.52
SD$67.52
TN$67.52
TX$67.52
UT$67.52
VA$67.52
VI$71.65
VT$67.52
WA$67.52
WI$67.52
WV$67.52
WY$67.52

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $67.00 to $80.40 depending on state and rural status.

Former-CBA payment limits: ceiling $67.00 · floor $56.95

StateNon-ruralRural
AK$67.00
AL$67.00
AR$67.00
AZ$67.00
CA$67.00
CO$67.00
CT$67.00
DC$67.00
DE$67.00
FL$67.00
GA$67.00
HI$67.00
IA$67.00
ID$67.00
IL$67.00
IN$67.00
KS$67.00
KY$67.00
LA$67.00
MA$67.00
MD$67.00
ME$67.00
MI$67.00
MN$67.00
MO$67.00
MS$67.00
MT$67.00
NC$67.00
ND$67.00
NE$67.00
NH$67.00
NJ$67.00
NM$67.00
NV$67.00
NY$67.00
OH$67.00
OK$67.00
OR$67.00
PA$67.00
PR$80.40
RI$67.00
SC$67.00
SD$67.00
TN$67.00
TX$67.00
UT$67.00
VA$67.00
VI$67.00
VT$67.00
WA$67.00
WI$67.00
WV$67.00
WY$67.00

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $4.87 to $7.35 depending on state and rural status.

StateNon-ruralRural
AK$6.69
AL$5.35$6.27
AR$5.35$6.27
AZ$5.27$6.27
CA$5.35$6.27
CO$5.47$6.27
CT$4.87$6.27
DC$4.90$6.27
DE$4.90$6.27
FL$5.35$6.27
GA$5.35$6.27
HI$6.69
IA$5.49$6.27
ID$5.47$6.27
IL$5.74$6.27
IN$5.74$6.27
KS$5.49$6.27
KY$5.35$6.27
LA$5.35$6.27
MA$4.87$6.27
MD$4.90$6.27
ME$4.87$6.27
MI$5.74$6.27
MN$5.49$6.27
MO$5.49$6.27
MS$5.35$6.27
MT$5.47$6.27
NC$5.35$6.27
ND$5.49$6.27
NE$5.49$6.27
NH$4.87$6.27
NJ$4.90$6.27
NM$5.27$6.27
NV$5.35$6.27
NY$4.90$6.27
OH$5.74$6.27
OK$5.27$6.27
OR$5.35$6.27
PA$4.90$6.27
PR$7.35
RI$4.87$6.27
SC$5.35$6.27
SD$5.49$6.27
TN$5.35$6.27
TX$5.27$6.27
UT$5.47$6.27
VA$5.35$6.27
VI$6.69
VT$4.87$6.27
WA$5.35$6.27
WI$5.74$6.27
WV$5.35$6.27
WY$5.47$6.27

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.76 to $7.93 depending on state and rural status.

StateNon-ruralRural
AK$7.17
AL$6.76
AR$6.76
AZ$6.76
CA$6.76
CO$6.76
CT$6.76
DC$6.76
DE$6.76
FL$6.76
GA$6.76
HI$7.17
IA$6.76
ID$6.76
IL$6.76
IN$6.76
KS$6.76
KY$6.76
LA$6.76
MA$6.76
MD$6.76
ME$6.76
MI$6.76
MN$6.76
MO$6.76
MS$6.76
MT$6.76
NC$6.76
ND$6.76
NE$6.76
NH$6.76
NJ$6.76
NM$6.76
NV$6.76
NY$6.76
OH$6.76
OK$6.76
OR$6.76
PA$6.76
PR$7.93
RI$6.76
SC$6.76
SD$6.76
TN$6.76
TX$6.76
UT$6.76
VA$6.76
VI$7.17
VT$6.76
WA$6.76
WI$6.76
WV$6.76
WY$6.76

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.71 to $8.02 depending on state and rural status.

Former-CBA payment limits: ceiling $6.71 · floor $5.70

StateNon-ruralRural
AK$6.71
AL$6.71
AR$6.71
AZ$6.71
CA$6.71
CO$6.71
CT$6.71
DC$6.71
DE$6.71
FL$6.71
GA$6.71
HI$6.71
IA$6.71
ID$6.71
IL$6.71
IN$6.71
KS$6.71
KY$6.71
LA$6.71
MA$6.71
MD$6.71
ME$6.71
MI$6.71
MN$6.71
MO$6.71
MS$6.71
MT$6.71
NC$6.71
ND$6.71
NE$6.71
NH$6.71
NJ$6.71
NM$6.71
NV$6.71
NY$6.71
OH$6.71
OK$6.71
OR$6.71
PA$6.71
PR$8.02
RI$6.71
SC$6.71
SD$6.71
TN$6.71
TX$6.71
UT$6.71
VA$6.71
VI$6.71
VT$6.71
WA$6.71
WI$6.71
WV$6.71
WY$6.71

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $36.53 to $55.13 depending on state and rural status.

StateNon-ruralRural
AK$50.10
AL$40.09$47.00
AR$40.09$47.00
AZ$39.55$47.00
CA$40.08$47.00
CO$41.06$47.00
CT$36.53$47.00
DC$36.76$47.00
DE$36.76$47.00
FL$40.09$47.00
GA$40.09$47.00
HI$50.10
IA$41.22$47.00
ID$41.06$47.00
IL$43.05$47.00
IN$43.05$47.00
KS$41.22$47.00
KY$40.09$47.00
LA$40.09$47.00
MA$36.53$47.00
MD$36.76$47.00
ME$36.53$47.00
MI$43.05$47.00
MN$41.22$47.00
MO$41.22$47.00
MS$40.09$47.00
MT$41.06$47.00
NC$40.09$47.00
ND$41.22$47.00
NE$41.22$47.00
NH$36.53$47.00
NJ$36.76$47.00
NM$39.55$47.00
NV$40.08$47.00
NY$36.76$47.00
OH$43.05$47.00
OK$39.55$47.00
OR$40.08$47.00
PA$36.76$47.00
PR$55.13
RI$36.53$47.00
SC$40.09$47.00
SD$41.22$47.00
TN$40.09$47.00
TX$39.55$47.00
UT$41.06$47.00
VA$40.09$47.00
VI$50.10
VT$36.53$47.00
WA$40.08$47.00
WI$43.05$47.00
WV$40.09$47.00
WY$41.06$47.00

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $50.65 to $59.50 depending on state and rural status.

StateNon-ruralRural
AK$53.75
AL$50.65
AR$50.65
AZ$50.65
CA$50.65
CO$50.65
CT$50.65
DC$50.65
DE$50.65
FL$50.65
GA$50.65
HI$53.75
IA$50.65
ID$50.65
IL$50.65
IN$50.65
KS$50.65
KY$50.65
LA$50.65
MA$50.65
MD$50.65
ME$50.65
MI$50.65
MN$50.65
MO$50.65
MS$50.65
MT$50.65
NC$50.65
ND$50.65
NE$50.65
NH$50.65
NJ$50.65
NM$50.65
NV$50.65
NY$50.65
OH$50.65
OK$50.65
OR$50.65
PA$50.65
PR$59.50
RI$50.65
SC$50.65
SD$50.65
TN$50.65
TX$50.65
UT$50.65
VA$50.65
VI$53.75
VT$50.65
WA$50.65
WI$50.65
WV$50.65
WY$50.65

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $50.25 to $60.33 depending on state and rural status.

Former-CBA payment limits: ceiling $50.25 · floor $42.71

StateNon-ruralRural
AK$50.25
AL$50.25
AR$50.25
AZ$50.25
CA$50.25
CO$50.25
CT$50.25
DC$50.25
DE$50.25
FL$50.25
GA$50.25
HI$50.25
IA$50.25
ID$50.25
IL$50.25
IN$50.25
KS$50.25
KY$50.25
LA$50.25
MA$50.25
MD$50.25
ME$50.25
MI$50.25
MN$50.25
MO$50.25
MS$50.25
MT$50.25
NC$50.25
ND$50.25
NE$50.25
NH$50.25
NJ$50.25
NM$50.25
NV$50.25
NY$50.25
OH$50.25
OK$50.25
OR$50.25
PA$50.25
PR$60.33
RI$50.25
SC$50.25
SD$50.25
TN$50.25
TX$50.25
UT$50.25
VA$50.25
VI$50.25
VT$50.25
WA$50.25
WI$50.25
WV$50.25
WY$50.25
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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