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E2613 — Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware

HCPCS Level II E-code · short descriptor: “Position back cush 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.

E2613 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $354.05 to $496.59 depending on state and rural status.

StateNon-ruralRural
AK$448.32
AL$382.76$448.32
AR$382.76$448.32
AZ$371.06$448.32
CA$354.05$448.32
CO$389.71$448.32
CT$370.49$448.32
DC$355.77$448.32
DE$355.77$448.32
FL$382.76$448.32
GA$382.76$448.32
HI$448.32
IA$386.30$448.32
ID$389.71$448.32
IL$386.32$448.32
IN$386.32$448.32
KS$386.30$448.32
KY$382.76$448.32
LA$382.76$448.32
MA$370.49$448.32
MD$355.77$448.32
ME$370.49$448.32
MI$386.32$448.32
MN$386.30$448.32
MO$386.30$448.32
MS$382.76$448.32
MT$389.71$448.32
NC$382.76$448.32
ND$386.30$448.32
NE$386.30$448.32
NH$370.49$448.32
NJ$355.77$448.32
NM$371.06$448.32
NV$354.05$448.32
NY$355.77$448.32
OH$386.32$448.32
OK$371.06$448.32
OR$354.05$448.32
PA$355.77$448.32
PR$496.59
RI$370.49$448.32
SC$382.76$448.32
SD$386.30$448.32
TN$382.76$448.32
TX$371.06$448.32
UT$389.71$448.32
VA$382.76$448.32
VI$448.32
VT$370.49$448.32
WA$354.05$448.32
WI$386.32$448.32
WV$382.76$448.32
WY$389.71$448.32

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $483.32 to $538.59 depending on state and rural status.

StateNon-ruralRural
AK$483.32
AL$483.32
AR$483.32
AZ$483.32
CA$483.32
CO$483.32
CT$483.32
DC$483.32
DE$483.32
FL$483.32
GA$483.32
HI$483.32
IA$483.32
ID$483.32
IL$483.32
IN$483.32
KS$483.32
KY$483.32
LA$483.32
MA$483.32
MD$483.32
ME$483.32
MI$483.32
MN$483.32
MO$483.32
MS$483.32
MT$483.32
NC$483.32
ND$483.32
NE$483.32
NH$483.32
NJ$483.32
NM$483.32
NV$483.32
NY$483.32
OH$483.32
OK$483.32
OR$483.32
PA$483.32
PR$538.59
RI$483.32
SC$483.32
SD$483.32
TN$483.32
TX$483.32
UT$483.32
VA$483.32
VI$483.32
VT$483.32
WA$483.32
WI$483.32
WV$483.32
WY$483.32

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $482.79 to $579.33 depending on state and rural status.

Former-CBA payment limits: ceiling $482.79 · floor $410.37

StateNon-ruralRural
AK$482.79
AL$482.79
AR$482.79
AZ$482.79
CA$482.79
CO$482.79
CT$482.79
DC$482.79
DE$482.79
FL$482.79
GA$482.79
HI$482.79
IA$482.79
ID$482.79
IL$482.79
IN$482.79
KS$482.79
KY$482.79
LA$482.79
MA$482.79
MD$482.79
ME$482.79
MI$482.79
MN$482.79
MO$482.79
MS$482.79
MT$482.79
NC$482.79
ND$482.79
NE$482.79
NH$482.79
NJ$482.79
NM$482.79
NV$482.79
NY$482.79
OH$482.79
OK$482.79
OR$482.79
PA$482.79
PR$579.33
RI$482.79
SC$482.79
SD$482.79
TN$482.79
TX$482.79
UT$482.79
VA$482.79
VI$482.79
VT$482.79
WA$482.79
WI$482.79
WV$482.79
WY$482.79

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $35.41 to $49.66 depending on state and rural status.

StateNon-ruralRural
AK$44.84
AL$38.28$44.84
AR$38.28$44.84
AZ$37.11$44.84
CA$35.41$44.84
CO$38.97$44.84
CT$37.05$44.84
DC$35.58$44.84
DE$35.58$44.84
FL$38.28$44.84
GA$38.28$44.84
HI$44.84
IA$38.63$44.84
ID$38.97$44.84
IL$38.63$44.84
IN$38.63$44.84
KS$38.63$44.84
KY$38.28$44.84
LA$38.28$44.84
MA$37.05$44.84
MD$35.58$44.84
ME$37.05$44.84
MI$38.63$44.84
MN$38.63$44.84
MO$38.63$44.84
MS$38.28$44.84
MT$38.97$44.84
NC$38.28$44.84
ND$38.63$44.84
NE$38.63$44.84
NH$37.05$44.84
NJ$35.58$44.84
NM$37.11$44.84
NV$35.41$44.84
NY$35.58$44.84
OH$38.63$44.84
OK$37.11$44.84
OR$35.41$44.84
PA$35.58$44.84
PR$49.66
RI$37.05$44.84
SC$38.28$44.84
SD$38.63$44.84
TN$38.28$44.84
TX$37.11$44.84
UT$38.97$44.84
VA$38.28$44.84
VI$44.84
VT$37.05$44.84
WA$35.41$44.84
WI$38.63$44.84
WV$38.28$44.84
WY$38.97$44.84

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $48.34 to $53.86 depending on state and rural status.

StateNon-ruralRural
AK$48.34
AL$48.34
AR$48.34
AZ$48.34
CA$48.34
CO$48.34
CT$48.34
DC$48.34
DE$48.34
FL$48.34
GA$48.34
HI$48.34
IA$48.34
ID$48.34
IL$48.34
IN$48.34
KS$48.34
KY$48.34
LA$48.34
MA$48.34
MD$48.34
ME$48.34
MI$48.34
MN$48.34
MO$48.34
MS$48.34
MT$48.34
NC$48.34
ND$48.34
NE$48.34
NH$48.34
NJ$48.34
NM$48.34
NV$48.34
NY$48.34
OH$48.34
OK$48.34
OR$48.34
PA$48.34
PR$53.86
RI$48.34
SC$48.34
SD$48.34
TN$48.34
TX$48.34
UT$48.34
VA$48.34
VI$48.34
VT$48.34
WA$48.34
WI$48.34
WV$48.34
WY$48.34

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $48.29 to $57.93 depending on state and rural status.

Former-CBA payment limits: ceiling $48.29 · floor $41.05

StateNon-ruralRural
AK$48.29
AL$48.29
AR$48.29
AZ$48.29
CA$48.29
CO$48.29
CT$48.29
DC$48.29
DE$48.29
FL$48.29
GA$48.29
HI$48.29
IA$48.29
ID$48.29
IL$48.29
IN$48.29
KS$48.29
KY$48.29
LA$48.29
MA$48.29
MD$48.29
ME$48.29
MI$48.29
MN$48.29
MO$48.29
MS$48.29
MT$48.29
NC$48.29
ND$48.29
NE$48.29
NH$48.29
NJ$48.29
NM$48.29
NV$48.29
NY$48.29
OH$48.29
OK$48.29
OR$48.29
PA$48.29
PR$57.93
RI$48.29
SC$48.29
SD$48.29
TN$48.29
TX$48.29
UT$48.29
VA$48.29
VI$48.29
VT$48.29
WA$48.29
WI$48.29
WV$48.29
WY$48.29

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $265.54 to $372.45 depending on state and rural status.

StateNon-ruralRural
AK$336.24
AL$287.07$336.24
AR$287.07$336.24
AZ$278.30$336.24
CA$265.54$336.24
CO$292.28$336.24
CT$277.87$336.24
DC$266.83$336.24
DE$266.83$336.24
FL$287.07$336.24
GA$287.07$336.24
HI$336.24
IA$289.73$336.24
ID$292.28$336.24
IL$289.74$336.24
IN$289.74$336.24
KS$289.73$336.24
KY$287.07$336.24
LA$287.07$336.24
MA$277.87$336.24
MD$266.83$336.24
ME$277.87$336.24
MI$289.74$336.24
MN$289.73$336.24
MO$289.73$336.24
MS$287.07$336.24
MT$292.28$336.24
NC$287.07$336.24
ND$289.73$336.24
NE$289.73$336.24
NH$277.87$336.24
NJ$266.83$336.24
NM$278.30$336.24
NV$265.54$336.24
NY$266.83$336.24
OH$289.74$336.24
OK$278.30$336.24
OR$265.54$336.24
PA$266.83$336.24
PR$372.45
RI$277.87$336.24
SC$287.07$336.24
SD$289.73$336.24
TN$287.07$336.24
TX$278.30$336.24
UT$292.28$336.24
VA$287.07$336.24
VI$336.24
VT$277.87$336.24
WA$265.54$336.24
WI$289.74$336.24
WV$287.07$336.24
WY$292.28$336.24

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $362.49 to $403.95 depending on state and rural status.

StateNon-ruralRural
AK$362.49
AL$362.49
AR$362.49
AZ$362.49
CA$362.49
CO$362.49
CT$362.49
DC$362.49
DE$362.49
FL$362.49
GA$362.49
HI$362.49
IA$362.49
ID$362.49
IL$362.49
IN$362.49
KS$362.49
KY$362.49
LA$362.49
MA$362.49
MD$362.49
ME$362.49
MI$362.49
MN$362.49
MO$362.49
MS$362.49
MT$362.49
NC$362.49
ND$362.49
NE$362.49
NH$362.49
NJ$362.49
NM$362.49
NV$362.49
NY$362.49
OH$362.49
OK$362.49
OR$362.49
PA$362.49
PR$403.95
RI$362.49
SC$362.49
SD$362.49
TN$362.49
TX$362.49
UT$362.49
VA$362.49
VI$362.49
VT$362.49
WA$362.49
WI$362.49
WV$362.49
WY$362.49

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $362.08 to $434.50 depending on state and rural status.

Former-CBA payment limits: ceiling $362.08 · floor $307.77

StateNon-ruralRural
AK$362.08
AL$362.08
AR$362.08
AZ$362.08
CA$362.08
CO$362.08
CT$362.08
DC$362.08
DE$362.08
FL$362.08
GA$362.08
HI$362.08
IA$362.08
ID$362.08
IL$362.08
IN$362.08
KS$362.08
KY$362.08
LA$362.08
MA$362.08
MD$362.08
ME$362.08
MI$362.08
MN$362.08
MO$362.08
MS$362.08
MT$362.08
NC$362.08
ND$362.08
NE$362.08
NH$362.08
NJ$362.08
NM$362.08
NV$362.08
NY$362.08
OH$362.08
OK$362.08
OR$362.08
PA$362.08
PR$434.50
RI$362.08
SC$362.08
SD$362.08
TN$362.08
TX$362.08
UT$362.08
VA$362.08
VI$362.08
VT$362.08
WA$362.08
WI$362.08
WV$362.08
WY$362.08
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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Related E-codes

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