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
- Face-to-face & WOPD
- Not on the required list
- MUE unit limit
- 1
- 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.
E2604 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $163.68 to $254.12 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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.
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2604 at 1 unit 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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