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E2604 — Skin protection wheelchair seat cushion, width 22 inches or greater, any depth

HCPCS Level II E-code · short descriptor: “Skin protect wc cus wd>=22in”

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

E2604 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $163.68 to $254.12 depending on state and rural status.

StateNon-ruralRural
AK$230.97
AL$180.35$213.28
AR$180.35$213.28
AZ$180.38$213.28
CA$177.30$213.28
CO$190.93$213.28
CT$163.68$213.28
DC$165.46$213.28
DE$165.46$213.28
FL$180.35$213.28
GA$180.35$213.28
HI$230.97
IA$181.94$213.28
ID$190.93$213.28
IL$178.87$213.28
IN$178.87$213.28
KS$181.94$213.28
KY$180.35$213.28
LA$180.35$213.28
MA$163.68$213.28
MD$165.46$213.28
ME$163.68$213.28
MI$178.87$213.28
MN$181.94$213.28
MO$181.94$213.28
MS$180.35$213.28
MT$190.93$213.28
NC$180.35$213.28
ND$181.94$213.28
NE$181.94$213.28
NH$163.68$213.28
NJ$165.46$213.28
NM$180.38$213.28
NV$177.30$213.28
NY$165.46$213.28
OH$178.87$213.28
OK$180.38$213.28
OR$177.30$213.28
PA$165.46$213.28
PR$254.12
RI$163.68$213.28
SC$180.35$213.28
SD$181.94$213.28
TN$180.35$213.28
TX$180.38$213.28
UT$190.93$213.28
VA$180.35$213.28
VI$230.97
VT$163.68$213.28
WA$177.30$213.28
WI$178.87$213.28
WV$180.35$213.28
WY$190.93$213.28

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $230.06 to $274.26 depending on state and rural status.

StateNon-ruralRural
AK$247.75
AL$230.06
AR$230.06
AZ$230.06
CA$230.06
CO$230.06
CT$230.06
DC$230.06
DE$230.06
FL$230.06
GA$230.06
HI$247.75
IA$230.06
ID$230.06
IL$230.06
IN$230.06
KS$230.06
KY$230.06
LA$230.06
MA$230.06
MD$230.06
ME$230.06
MI$230.06
MN$230.06
MO$230.06
MS$230.06
MT$230.06
NC$230.06
ND$230.06
NE$230.06
NH$230.06
NJ$230.06
NM$230.06
NV$230.06
NY$230.06
OH$230.06
OK$230.06
OR$230.06
PA$230.06
PR$274.26
RI$230.06
SC$230.06
SD$230.06
TN$230.06
TX$230.06
UT$230.06
VA$230.06
VI$247.75
VT$230.06
WA$230.06
WI$230.06
WV$230.06
WY$230.06

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $231.45 to $277.75 depending on state and rural status.

Former-CBA payment limits: ceiling $231.45 · floor $196.73

StateNon-ruralRural
AK$231.45
AL$231.45
AR$231.45
AZ$231.45
CA$231.45
CO$231.45
CT$231.45
DC$231.45
DE$231.45
FL$231.45
GA$231.45
HI$231.45
IA$231.45
ID$231.45
IL$231.45
IN$231.45
KS$231.45
KY$231.45
LA$231.45
MA$231.45
MD$231.45
ME$231.45
MI$231.45
MN$231.45
MO$231.45
MS$231.45
MT$231.45
NC$231.45
ND$231.45
NE$231.45
NH$231.45
NJ$231.45
NM$231.45
NV$231.45
NY$231.45
OH$231.45
OK$231.45
OR$231.45
PA$231.45
PR$277.75
RI$231.45
SC$231.45
SD$231.45
TN$231.45
TX$231.45
UT$231.45
VA$231.45
VI$231.45
VT$231.45
WA$231.45
WI$231.45
WV$231.45
WY$231.45

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $16.37 to $25.42 depending on state and rural status.

StateNon-ruralRural
AK$23.09
AL$18.04$21.33
AR$18.04$21.33
AZ$18.04$21.33
CA$17.73$21.33
CO$19.09$21.33
CT$16.37$21.33
DC$16.55$21.33
DE$16.55$21.33
FL$18.04$21.33
GA$18.04$21.33
HI$23.09
IA$18.19$21.33
ID$19.09$21.33
IL$17.89$21.33
IN$17.89$21.33
KS$18.19$21.33
KY$18.04$21.33
LA$18.04$21.33
MA$16.37$21.33
MD$16.55$21.33
ME$16.37$21.33
MI$17.89$21.33
MN$18.19$21.33
MO$18.19$21.33
MS$18.04$21.33
MT$19.09$21.33
NC$18.04$21.33
ND$18.19$21.33
NE$18.19$21.33
NH$16.37$21.33
NJ$16.55$21.33
NM$18.04$21.33
NV$17.73$21.33
NY$16.55$21.33
OH$17.89$21.33
OK$18.04$21.33
OR$17.73$21.33
PA$16.55$21.33
PR$25.42
RI$16.37$21.33
SC$18.04$21.33
SD$18.19$21.33
TN$18.04$21.33
TX$18.04$21.33
UT$19.09$21.33
VA$18.04$21.33
VI$23.09
VT$16.37$21.33
WA$17.73$21.33
WI$17.89$21.33
WV$18.04$21.33
WY$19.09$21.33

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $23.00 to $27.43 depending on state and rural status.

StateNon-ruralRural
AK$24.77
AL$23.00
AR$23.00
AZ$23.00
CA$23.00
CO$23.00
CT$23.00
DC$23.00
DE$23.00
FL$23.00
GA$23.00
HI$24.77
IA$23.00
ID$23.00
IL$23.00
IN$23.00
KS$23.00
KY$23.00
LA$23.00
MA$23.00
MD$23.00
ME$23.00
MI$23.00
MN$23.00
MO$23.00
MS$23.00
MT$23.00
NC$23.00
ND$23.00
NE$23.00
NH$23.00
NJ$23.00
NM$23.00
NV$23.00
NY$23.00
OH$23.00
OK$23.00
OR$23.00
PA$23.00
PR$27.43
RI$23.00
SC$23.00
SD$23.00
TN$23.00
TX$23.00
UT$23.00
VA$23.00
VI$24.77
VT$23.00
WA$23.00
WI$23.00
WV$23.00
WY$23.00

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $23.14 to $27.77 depending on state and rural status.

Former-CBA payment limits: ceiling $23.14 · floor $19.67

StateNon-ruralRural
AK$23.14
AL$23.14
AR$23.14
AZ$23.14
CA$23.14
CO$23.14
CT$23.14
DC$23.14
DE$23.14
FL$23.14
GA$23.14
HI$23.14
IA$23.14
ID$23.14
IL$23.14
IN$23.14
KS$23.14
KY$23.14
LA$23.14
MA$23.14
MD$23.14
ME$23.14
MI$23.14
MN$23.14
MO$23.14
MS$23.14
MT$23.14
NC$23.14
ND$23.14
NE$23.14
NH$23.14
NJ$23.14
NM$23.14
NV$23.14
NY$23.14
OH$23.14
OK$23.14
OR$23.14
PA$23.14
PR$27.77
RI$23.14
SC$23.14
SD$23.14
TN$23.14
TX$23.14
UT$23.14
VA$23.14
VI$23.14
VT$23.14
WA$23.14
WI$23.14
WV$23.14
WY$23.14

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $122.76 to $190.61 depending on state and rural status.

StateNon-ruralRural
AK$173.24
AL$135.27$159.98
AR$135.27$159.98
AZ$135.29$159.98
CA$132.98$159.98
CO$143.20$159.98
CT$122.76$159.98
DC$124.10$159.98
DE$124.10$159.98
FL$135.27$159.98
GA$135.27$159.98
HI$173.24
IA$136.46$159.98
ID$143.20$159.98
IL$134.16$159.98
IN$134.16$159.98
KS$136.46$159.98
KY$135.27$159.98
LA$135.27$159.98
MA$122.76$159.98
MD$124.10$159.98
ME$122.76$159.98
MI$134.16$159.98
MN$136.46$159.98
MO$136.46$159.98
MS$135.27$159.98
MT$143.20$159.98
NC$135.27$159.98
ND$136.46$159.98
NE$136.46$159.98
NH$122.76$159.98
NJ$124.10$159.98
NM$135.29$159.98
NV$132.98$159.98
NY$124.10$159.98
OH$134.16$159.98
OK$135.29$159.98
OR$132.98$159.98
PA$124.10$159.98
PR$190.61
RI$122.76$159.98
SC$135.27$159.98
SD$136.46$159.98
TN$135.27$159.98
TX$135.29$159.98
UT$143.20$159.98
VA$135.27$159.98
VI$173.24
VT$122.76$159.98
WA$132.98$159.98
WI$134.16$159.98
WV$135.27$159.98
WY$143.20$159.98

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $172.57 to $205.71 depending on state and rural status.

StateNon-ruralRural
AK$185.83
AL$172.57
AR$172.57
AZ$172.57
CA$172.57
CO$172.57
CT$172.57
DC$172.57
DE$172.57
FL$172.57
GA$172.57
HI$185.83
IA$172.57
ID$172.57
IL$172.57
IN$172.57
KS$172.57
KY$172.57
LA$172.57
MA$172.57
MD$172.57
ME$172.57
MI$172.57
MN$172.57
MO$172.57
MS$172.57
MT$172.57
NC$172.57
ND$172.57
NE$172.57
NH$172.57
NJ$172.57
NM$172.57
NV$172.57
NY$172.57
OH$172.57
OK$172.57
OR$172.57
PA$172.57
PR$205.71
RI$172.57
SC$172.57
SD$172.57
TN$172.57
TX$172.57
UT$172.57
VA$172.57
VI$185.83
VT$172.57
WA$172.57
WI$172.57
WV$172.57
WY$172.57

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $173.58 to $208.32 depending on state and rural status.

Former-CBA payment limits: ceiling $173.58 · floor $147.54

StateNon-ruralRural
AK$173.58
AL$173.58
AR$173.58
AZ$173.58
CA$173.58
CO$173.58
CT$173.58
DC$173.58
DE$173.58
FL$173.58
GA$173.58
HI$173.58
IA$173.58
ID$173.58
IL$173.58
IN$173.58
KS$173.58
KY$173.58
LA$173.58
MA$173.58
MD$173.58
ME$173.58
MI$173.58
MN$173.58
MO$173.58
MS$173.58
MT$173.58
NC$173.58
ND$173.58
NE$173.58
NH$173.58
NJ$173.58
NM$173.58
NV$173.58
NY$173.58
OH$173.58
OK$173.58
OR$173.58
PA$173.58
PR$208.32
RI$173.58
SC$173.58
SD$173.58
TN$173.58
TX$173.58
UT$173.58
VA$173.58
VI$173.58
VT$173.58
WA$173.58
WI$173.58
WV$173.58
WY$173.58
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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