E2616 — Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware
HCPCS Level II E-code · short descriptor: “Pos back post/lat wdth>=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.
E2616 Medicare fee schedule (April 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $545.28 to $821.18 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $746.41 | — |
| AL | $581.73 | $691.68 |
| AR | $581.73 | $691.68 |
| AZ | $571.15 | $691.68 |
| CA | $569.71 | $691.68 |
| CO | $596.88 | $691.68 |
| CT | $566.86 | $691.68 |
| DC | $545.28 | $691.68 |
| DE | $545.28 | $691.68 |
| FL | $581.73 | $691.68 |
| GA | $581.73 | $691.68 |
| HI | $746.41 | — |
| IA | $585.94 | $691.68 |
| ID | $596.88 | $691.68 |
| IL | $604.11 | $691.68 |
| IN | $604.11 | $691.68 |
| KS | $585.94 | $691.68 |
| KY | $581.73 | $691.68 |
| LA | $581.73 | $691.68 |
| MA | $566.86 | $691.68 |
| MD | $545.28 | $691.68 |
| ME | $566.86 | $691.68 |
| MI | $604.11 | $691.68 |
| MN | $585.94 | $691.68 |
| MO | $585.94 | $691.68 |
| MS | $581.73 | $691.68 |
| MT | $596.88 | $691.68 |
| NC | $581.73 | $691.68 |
| ND | $585.94 | $691.68 |
| NE | $585.94 | $691.68 |
| NH | $566.86 | $691.68 |
| NJ | $545.28 | $691.68 |
| NM | $571.15 | $691.68 |
| NV | $569.71 | $691.68 |
| NY | $545.28 | $691.68 |
| OH | $604.11 | $691.68 |
| OK | $571.15 | $691.68 |
| OR | $569.71 | $691.68 |
| PA | $545.28 | $691.68 |
| PR | $821.18 | — |
| RI | $566.86 | $691.68 |
| SC | $581.73 | $691.68 |
| SD | $585.94 | $691.68 |
| TN | $581.73 | $691.68 |
| TX | $571.15 | $691.68 |
| UT | $596.88 | $691.68 |
| VA | $581.73 | $691.68 |
| VI | $746.41 | — |
| VT | $566.86 | $691.68 |
| WA | $569.71 | $691.68 |
| WI | $604.11 | $691.68 |
| WV | $581.73 | $691.68 |
| WY | $596.88 | $691.68 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $745.88 to $886.21 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $800.61 | — |
| AL | — | $745.88 |
| AR | — | $745.88 |
| AZ | — | $745.88 |
| CA | — | $745.88 |
| CO | — | $745.88 |
| CT | — | $745.88 |
| DC | — | $745.88 |
| DE | — | $745.88 |
| FL | — | $745.88 |
| GA | — | $745.88 |
| HI | $800.61 | — |
| IA | — | $745.88 |
| ID | — | $745.88 |
| IL | — | $745.88 |
| IN | — | $745.88 |
| KS | — | $745.88 |
| KY | — | $745.88 |
| LA | — | $745.88 |
| MA | — | $745.88 |
| MD | — | $745.88 |
| ME | — | $745.88 |
| MI | — | $745.88 |
| MN | — | $745.88 |
| MO | — | $745.88 |
| MS | — | $745.88 |
| MT | — | $745.88 |
| NC | — | $745.88 |
| ND | — | $745.88 |
| NE | — | $745.88 |
| NH | — | $745.88 |
| NJ | — | $745.88 |
| NM | — | $745.88 |
| NV | — | $745.88 |
| NY | — | $745.88 |
| OH | — | $745.88 |
| OK | — | $745.88 |
| OR | — | $745.88 |
| PA | — | $745.88 |
| PR | $886.21 | — |
| RI | — | $745.88 |
| SC | — | $745.88 |
| SD | — | $745.88 |
| TN | — | $745.88 |
| TX | — | $745.88 |
| UT | — | $745.88 |
| VA | — | $745.88 |
| VI | $800.61 | — |
| VT | — | $745.88 |
| WA | — | $745.88 |
| WI | — | $745.88 |
| WV | — | $745.88 |
| WY | — | $745.88 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $747.55 to $897.06 depending on state and rural status.
Former-CBA payment limits: ceiling $747.55 · floor $635.42
| State | Non-rural | Rural |
|---|---|---|
| AK | $747.55 | — |
| AL | $747.55 | — |
| AR | $747.55 | — |
| AZ | $747.55 | — |
| CA | $747.55 | — |
| CO | $747.55 | — |
| CT | $747.55 | — |
| DC | $747.55 | — |
| DE | $747.55 | — |
| FL | $747.55 | — |
| GA | $747.55 | — |
| HI | $747.55 | — |
| IA | $747.55 | — |
| ID | $747.55 | — |
| IL | $747.55 | — |
| IN | $747.55 | — |
| KS | $747.55 | — |
| KY | $747.55 | — |
| LA | $747.55 | — |
| MA | $747.55 | — |
| MD | $747.55 | — |
| ME | $747.55 | — |
| MI | $747.55 | — |
| MN | $747.55 | — |
| MO | $747.55 | — |
| MS | $747.55 | — |
| MT | $747.55 | — |
| NC | $747.55 | — |
| ND | $747.55 | — |
| NE | $747.55 | — |
| NH | $747.55 | — |
| NJ | $747.55 | — |
| NM | $747.55 | — |
| NV | $747.55 | — |
| NY | $747.55 | — |
| OH | $747.55 | — |
| OK | $747.55 | — |
| OR | $747.55 | — |
| PA | $747.55 | — |
| PR | $897.06 | — |
| RI | $747.55 | — |
| SC | $747.55 | — |
| SD | $747.55 | — |
| TN | $747.55 | — |
| TX | $747.55 | — |
| UT | $747.55 | — |
| VA | $747.55 | — |
| VI | $747.55 | — |
| VT | $747.55 | — |
| WA | $747.55 | — |
| WI | $747.55 | — |
| WV | $747.55 | — |
| WY | $747.55 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $54.53 to $82.11 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $74.64 | — |
| AL | $58.17 | $69.17 |
| AR | $58.17 | $69.17 |
| AZ | $57.12 | $69.17 |
| CA | $56.97 | $69.17 |
| CO | $59.69 | $69.17 |
| CT | $56.68 | $69.17 |
| DC | $54.53 | $69.17 |
| DE | $54.53 | $69.17 |
| FL | $58.17 | $69.17 |
| GA | $58.17 | $69.17 |
| HI | $74.64 | — |
| IA | $58.59 | $69.17 |
| ID | $59.69 | $69.17 |
| IL | $60.41 | $69.17 |
| IN | $60.41 | $69.17 |
| KS | $58.59 | $69.17 |
| KY | $58.17 | $69.17 |
| LA | $58.17 | $69.17 |
| MA | $56.68 | $69.17 |
| MD | $54.53 | $69.17 |
| ME | $56.68 | $69.17 |
| MI | $60.41 | $69.17 |
| MN | $58.59 | $69.17 |
| MO | $58.59 | $69.17 |
| MS | $58.17 | $69.17 |
| MT | $59.69 | $69.17 |
| NC | $58.17 | $69.17 |
| ND | $58.59 | $69.17 |
| NE | $58.59 | $69.17 |
| NH | $56.68 | $69.17 |
| NJ | $54.53 | $69.17 |
| NM | $57.12 | $69.17 |
| NV | $56.97 | $69.17 |
| NY | $54.53 | $69.17 |
| OH | $60.41 | $69.17 |
| OK | $57.12 | $69.17 |
| OR | $56.97 | $69.17 |
| PA | $54.53 | $69.17 |
| PR | $82.11 | — |
| RI | $56.68 | $69.17 |
| SC | $58.17 | $69.17 |
| SD | $58.59 | $69.17 |
| TN | $58.17 | $69.17 |
| TX | $57.12 | $69.17 |
| UT | $59.69 | $69.17 |
| VA | $58.17 | $69.17 |
| VI | $74.64 | — |
| VT | $56.68 | $69.17 |
| WA | $56.97 | $69.17 |
| WI | $60.41 | $69.17 |
| WV | $58.17 | $69.17 |
| WY | $59.69 | $69.17 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $74.59 to $88.61 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $80.06 | — |
| AL | — | $74.59 |
| AR | — | $74.59 |
| AZ | — | $74.59 |
| CA | — | $74.59 |
| CO | — | $74.59 |
| CT | — | $74.59 |
| DC | — | $74.59 |
| DE | — | $74.59 |
| FL | — | $74.59 |
| GA | — | $74.59 |
| HI | $80.06 | — |
| IA | — | $74.59 |
| ID | — | $74.59 |
| IL | — | $74.59 |
| IN | — | $74.59 |
| KS | — | $74.59 |
| KY | — | $74.59 |
| LA | — | $74.59 |
| MA | — | $74.59 |
| MD | — | $74.59 |
| ME | — | $74.59 |
| MI | — | $74.59 |
| MN | — | $74.59 |
| MO | — | $74.59 |
| MS | — | $74.59 |
| MT | — | $74.59 |
| NC | — | $74.59 |
| ND | — | $74.59 |
| NE | — | $74.59 |
| NH | — | $74.59 |
| NJ | — | $74.59 |
| NM | — | $74.59 |
| NV | — | $74.59 |
| NY | — | $74.59 |
| OH | — | $74.59 |
| OK | — | $74.59 |
| OR | — | $74.59 |
| PA | — | $74.59 |
| PR | $88.61 | — |
| RI | — | $74.59 |
| SC | — | $74.59 |
| SD | — | $74.59 |
| TN | — | $74.59 |
| TX | — | $74.59 |
| UT | — | $74.59 |
| VA | — | $74.59 |
| VI | $80.06 | — |
| VT | — | $74.59 |
| WA | — | $74.59 |
| WI | — | $74.59 |
| WV | — | $74.59 |
| WY | — | $74.59 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $74.75 to $89.70 depending on state and rural status.
Former-CBA payment limits: ceiling $74.75 · floor $63.54
| State | Non-rural | Rural |
|---|---|---|
| AK | $74.75 | — |
| AL | $74.75 | — |
| AR | $74.75 | — |
| AZ | $74.75 | — |
| CA | $74.75 | — |
| CO | $74.75 | — |
| CT | $74.75 | — |
| DC | $74.75 | — |
| DE | $74.75 | — |
| FL | $74.75 | — |
| GA | $74.75 | — |
| HI | $74.75 | — |
| IA | $74.75 | — |
| ID | $74.75 | — |
| IL | $74.75 | — |
| IN | $74.75 | — |
| KS | $74.75 | — |
| KY | $74.75 | — |
| LA | $74.75 | — |
| MA | $74.75 | — |
| MD | $74.75 | — |
| ME | $74.75 | — |
| MI | $74.75 | — |
| MN | $74.75 | — |
| MO | $74.75 | — |
| MS | $74.75 | — |
| MT | $74.75 | — |
| NC | $74.75 | — |
| ND | $74.75 | — |
| NE | $74.75 | — |
| NH | $74.75 | — |
| NJ | $74.75 | — |
| NM | $74.75 | — |
| NV | $74.75 | — |
| NY | $74.75 | — |
| OH | $74.75 | — |
| OK | $74.75 | — |
| OR | $74.75 | — |
| PA | $74.75 | — |
| PR | $89.70 | — |
| RI | $74.75 | — |
| SC | $74.75 | — |
| SD | $74.75 | — |
| TN | $74.75 | — |
| TX | $74.75 | — |
| UT | $74.75 | — |
| VA | $74.75 | — |
| VI | $74.75 | — |
| VT | $74.75 | — |
| WA | $74.75 | — |
| WI | $74.75 | — |
| WV | $74.75 | — |
| WY | $74.75 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $408.96 to $615.86 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $559.82 | — |
| AL | $436.30 | $518.77 |
| AR | $436.30 | $518.77 |
| AZ | $428.37 | $518.77 |
| CA | $427.28 | $518.77 |
| CO | $447.66 | $518.77 |
| CT | $425.15 | $518.77 |
| DC | $408.96 | $518.77 |
| DE | $408.96 | $518.77 |
| FL | $436.30 | $518.77 |
| GA | $436.30 | $518.77 |
| HI | $559.82 | — |
| IA | $439.45 | $518.77 |
| ID | $447.66 | $518.77 |
| IL | $453.08 | $518.77 |
| IN | $453.08 | $518.77 |
| KS | $439.45 | $518.77 |
| KY | $436.30 | $518.77 |
| LA | $436.30 | $518.77 |
| MA | $425.15 | $518.77 |
| MD | $408.96 | $518.77 |
| ME | $425.15 | $518.77 |
| MI | $453.08 | $518.77 |
| MN | $439.45 | $518.77 |
| MO | $439.45 | $518.77 |
| MS | $436.30 | $518.77 |
| MT | $447.66 | $518.77 |
| NC | $436.30 | $518.77 |
| ND | $439.45 | $518.77 |
| NE | $439.45 | $518.77 |
| NH | $425.15 | $518.77 |
| NJ | $408.96 | $518.77 |
| NM | $428.37 | $518.77 |
| NV | $427.28 | $518.77 |
| NY | $408.96 | $518.77 |
| OH | $453.08 | $518.77 |
| OK | $428.37 | $518.77 |
| OR | $427.28 | $518.77 |
| PA | $408.96 | $518.77 |
| PR | $615.86 | — |
| RI | $425.15 | $518.77 |
| SC | $436.30 | $518.77 |
| SD | $439.45 | $518.77 |
| TN | $436.30 | $518.77 |
| TX | $428.37 | $518.77 |
| UT | $447.66 | $518.77 |
| VA | $436.30 | $518.77 |
| VI | $559.82 | — |
| VT | $425.15 | $518.77 |
| WA | $427.28 | $518.77 |
| WI | $453.08 | $518.77 |
| WV | $436.30 | $518.77 |
| WY | $447.66 | $518.77 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $559.42 to $664.64 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $600.46 | — |
| AL | — | $559.42 |
| AR | — | $559.42 |
| AZ | — | $559.42 |
| CA | — | $559.42 |
| CO | — | $559.42 |
| CT | — | $559.42 |
| DC | — | $559.42 |
| DE | — | $559.42 |
| FL | — | $559.42 |
| GA | — | $559.42 |
| HI | $600.46 | — |
| IA | — | $559.42 |
| ID | — | $559.42 |
| IL | — | $559.42 |
| IN | — | $559.42 |
| KS | — | $559.42 |
| KY | — | $559.42 |
| LA | — | $559.42 |
| MA | — | $559.42 |
| MD | — | $559.42 |
| ME | — | $559.42 |
| MI | — | $559.42 |
| MN | — | $559.42 |
| MO | — | $559.42 |
| MS | — | $559.42 |
| MT | — | $559.42 |
| NC | — | $559.42 |
| ND | — | $559.42 |
| NE | — | $559.42 |
| NH | — | $559.42 |
| NJ | — | $559.42 |
| NM | — | $559.42 |
| NV | — | $559.42 |
| NY | — | $559.42 |
| OH | — | $559.42 |
| OK | — | $559.42 |
| OR | — | $559.42 |
| PA | — | $559.42 |
| PR | $664.64 | — |
| RI | — | $559.42 |
| SC | — | $559.42 |
| SD | — | $559.42 |
| TN | — | $559.42 |
| TX | — | $559.42 |
| UT | — | $559.42 |
| VA | — | $559.42 |
| VI | $600.46 | — |
| VT | — | $559.42 |
| WA | — | $559.42 |
| WI | — | $559.42 |
| WV | — | $559.42 |
| WY | — | $559.42 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $560.65 to $672.76 depending on state and rural status.
Former-CBA payment limits: ceiling $560.65 · floor $476.55
| State | Non-rural | Rural |
|---|---|---|
| AK | $560.65 | — |
| AL | $560.65 | — |
| AR | $560.65 | — |
| AZ | $560.65 | — |
| CA | $560.65 | — |
| CO | $560.65 | — |
| CT | $560.65 | — |
| DC | $560.65 | — |
| DE | $560.65 | — |
| FL | $560.65 | — |
| GA | $560.65 | — |
| HI | $560.65 | — |
| IA | $560.65 | — |
| ID | $560.65 | — |
| IL | $560.65 | — |
| IN | $560.65 | — |
| KS | $560.65 | — |
| KY | $560.65 | — |
| LA | $560.65 | — |
| MA | $560.65 | — |
| MD | $560.65 | — |
| ME | $560.65 | — |
| MI | $560.65 | — |
| MN | $560.65 | — |
| MO | $560.65 | — |
| MS | $560.65 | — |
| MT | $560.65 | — |
| NC | $560.65 | — |
| ND | $560.65 | — |
| NE | $560.65 | — |
| NH | $560.65 | — |
| NJ | $560.65 | — |
| NM | $560.65 | — |
| NV | $560.65 | — |
| NY | $560.65 | — |
| OH | $560.65 | — |
| OK | $560.65 | — |
| OR | $560.65 | — |
| PA | $560.65 | — |
| PR | $672.76 | — |
| RI | $560.65 | — |
| SC | $560.65 | — |
| SD | $560.65 | — |
| TN | $560.65 | — |
| TX | $560.65 | — |
| UT | $560.65 | — |
| VA | $560.65 | — |
| VI | $560.65 | — |
| VT | $560.65 | — |
| WA | $560.65 | — |
| WI | $560.65 | — |
| WV | $560.65 | — |
| WY | $560.65 | — |
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