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E2619 — Replacement cover for wheelchair seat cushion or back cushion, each

HCPCS Level II E-code · short descriptor: “Replace cover w/c seat cush”

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.

E2619 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $61.28 to $68.45 depending on state and rural status.

StateNon-ruralRural
AK$62.16
AL$61.28$62.16
AR$61.28$62.16
AZ$61.28$62.16
CA$61.28$62.16
CO$61.28$62.16
CT$61.28$62.16
DC$61.28$62.16
DE$61.28$62.16
FL$61.28$62.16
GA$61.28$62.16
HI$62.16
IA$61.28$62.16
ID$61.28$62.16
IL$61.28$62.16
IN$61.28$62.16
KS$61.28$62.16
KY$61.28$62.16
LA$61.28$62.16
MA$61.28$62.16
MD$61.28$62.16
ME$61.28$62.16
MI$61.28$62.16
MN$61.28$62.16
MO$61.28$62.16
MS$61.28$62.16
MT$61.28$62.16
NC$61.28$62.16
ND$61.28$62.16
NE$61.28$62.16
NH$61.28$62.16
NJ$61.28$62.16
NM$61.28$62.16
NV$61.28$62.16
NY$61.28$62.16
OH$61.28$62.16
OK$61.28$62.16
OR$61.28$62.16
PA$61.28$62.16
PR$68.45
RI$61.28$62.16
SC$61.28$62.16
SD$61.28$62.16
TN$61.28$62.16
TX$61.28$62.16
UT$61.28$62.16
VA$61.28$62.16
VI$62.16
VT$61.28$62.16
WA$61.28$62.16
WI$61.28$62.16
WV$61.28$62.16
WY$61.28$62.16

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $66.73 to $73.94 depending on state and rural status.

StateNon-ruralRural
AK$66.73
AL$66.73
AR$66.73
AZ$66.73
CA$66.73
CO$66.73
CT$66.73
DC$66.73
DE$66.73
FL$66.73
GA$66.73
HI$66.73
IA$66.73
ID$66.73
IL$66.73
IN$66.73
KS$66.73
KY$66.73
LA$66.73
MA$66.73
MD$66.73
ME$66.73
MI$66.73
MN$66.73
MO$66.73
MS$66.73
MT$66.73
NC$66.73
ND$66.73
NE$66.73
NH$66.73
NJ$66.73
NM$66.73
NV$66.73
NY$66.73
OH$66.73
OK$66.73
OR$66.73
PA$66.73
PR$73.94
RI$66.73
SC$66.73
SD$66.73
TN$66.73
TX$66.73
UT$66.73
VA$66.73
VI$66.73
VT$66.73
WA$66.73
WI$66.73
WV$66.73
WY$66.73

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $63.02 to $75.61 depending on state and rural status.

Former-CBA payment limits: ceiling $63.02 · floor $53.57

StateNon-ruralRural
AK$63.02
AL$63.02
AR$63.02
AZ$63.02
CA$63.02
CO$63.02
CT$63.02
DC$63.02
DE$63.02
FL$63.02
GA$63.02
HI$63.02
IA$63.02
ID$63.02
IL$63.02
IN$63.02
KS$63.02
KY$63.02
LA$63.02
MA$63.02
MD$63.02
ME$63.02
MI$63.02
MN$63.02
MO$63.02
MS$63.02
MT$63.02
NC$63.02
ND$63.02
NE$63.02
NH$63.02
NJ$63.02
NM$63.02
NV$63.02
NY$63.02
OH$63.02
OK$63.02
OR$63.02
PA$63.02
PR$75.61
RI$63.02
SC$63.02
SD$63.02
TN$63.02
TX$63.02
UT$63.02
VA$63.02
VI$63.02
VT$63.02
WA$63.02
WI$63.02
WV$63.02
WY$63.02

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.13 to $6.86 depending on state and rural status.

StateNon-ruralRural
AK$6.22
AL$6.13$6.22
AR$6.13$6.22
AZ$6.13$6.22
CA$6.13$6.22
CO$6.13$6.22
CT$6.13$6.22
DC$6.13$6.22
DE$6.13$6.22
FL$6.13$6.22
GA$6.13$6.22
HI$6.22
IA$6.13$6.22
ID$6.13$6.22
IL$6.13$6.22
IN$6.13$6.22
KS$6.13$6.22
KY$6.13$6.22
LA$6.13$6.22
MA$6.13$6.22
MD$6.13$6.22
ME$6.13$6.22
MI$6.13$6.22
MN$6.13$6.22
MO$6.13$6.22
MS$6.13$6.22
MT$6.13$6.22
NC$6.13$6.22
ND$6.13$6.22
NE$6.13$6.22
NH$6.13$6.22
NJ$6.13$6.22
NM$6.13$6.22
NV$6.13$6.22
NY$6.13$6.22
OH$6.13$6.22
OK$6.13$6.22
OR$6.13$6.22
PA$6.13$6.22
PR$6.86
RI$6.13$6.22
SC$6.13$6.22
SD$6.13$6.22
TN$6.13$6.22
TX$6.13$6.22
UT$6.13$6.22
VA$6.13$6.22
VI$6.22
VT$6.13$6.22
WA$6.13$6.22
WI$6.13$6.22
WV$6.13$6.22
WY$6.13$6.22

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.67 to $7.41 depending on state and rural status.

StateNon-ruralRural
AK$6.67
AL$6.67
AR$6.67
AZ$6.67
CA$6.67
CO$6.67
CT$6.67
DC$6.67
DE$6.67
FL$6.67
GA$6.67
HI$6.67
IA$6.67
ID$6.67
IL$6.67
IN$6.67
KS$6.67
KY$6.67
LA$6.67
MA$6.67
MD$6.67
ME$6.67
MI$6.67
MN$6.67
MO$6.67
MS$6.67
MT$6.67
NC$6.67
ND$6.67
NE$6.67
NH$6.67
NJ$6.67
NM$6.67
NV$6.67
NY$6.67
OH$6.67
OK$6.67
OR$6.67
PA$6.67
PR$7.41
RI$6.67
SC$6.67
SD$6.67
TN$6.67
TX$6.67
UT$6.67
VA$6.67
VI$6.67
VT$6.67
WA$6.67
WI$6.67
WV$6.67
WY$6.67

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.28 to $7.60 depending on state and rural status.

Former-CBA payment limits: ceiling $6.28 · floor $5.34

StateNon-ruralRural
AK$6.28
AL$6.28
AR$6.28
AZ$6.28
CA$6.28
CO$6.28
CT$6.28
DC$6.28
DE$6.28
FL$6.28
GA$6.28
HI$6.28
IA$6.28
ID$6.28
IL$6.28
IN$6.28
KS$6.28
KY$6.28
LA$6.28
MA$6.28
MD$6.28
ME$6.28
MI$6.28
MN$6.28
MO$6.28
MS$6.28
MT$6.28
NC$6.28
ND$6.28
NE$6.28
NH$6.28
NJ$6.28
NM$6.28
NV$6.28
NY$6.28
OH$6.28
OK$6.28
OR$6.28
PA$6.28
PR$7.60
RI$6.28
SC$6.28
SD$6.28
TN$6.28
TX$6.28
UT$6.28
VA$6.28
VI$6.28
VT$6.28
WA$6.28
WI$6.28
WV$6.28
WY$6.28

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $45.96 to $51.33 depending on state and rural status.

StateNon-ruralRural
AK$46.64
AL$45.96$46.64
AR$45.96$46.64
AZ$45.96$46.64
CA$45.96$46.64
CO$45.96$46.64
CT$45.96$46.64
DC$45.96$46.64
DE$45.96$46.64
FL$45.96$46.64
GA$45.96$46.64
HI$46.64
IA$45.96$46.64
ID$45.96$46.64
IL$45.96$46.64
IN$45.96$46.64
KS$45.96$46.64
KY$45.96$46.64
LA$45.96$46.64
MA$45.96$46.64
MD$45.96$46.64
ME$45.96$46.64
MI$45.96$46.64
MN$45.96$46.64
MO$45.96$46.64
MS$45.96$46.64
MT$45.96$46.64
NC$45.96$46.64
ND$45.96$46.64
NE$45.96$46.64
NH$45.96$46.64
NJ$45.96$46.64
NM$45.96$46.64
NV$45.96$46.64
NY$45.96$46.64
OH$45.96$46.64
OK$45.96$46.64
OR$45.96$46.64
PA$45.96$46.64
PR$51.33
RI$45.96$46.64
SC$45.96$46.64
SD$45.96$46.64
TN$45.96$46.64
TX$45.96$46.64
UT$45.96$46.64
VA$45.96$46.64
VI$46.64
VT$45.96$46.64
WA$45.96$46.64
WI$45.96$46.64
WV$45.96$46.64
WY$45.96$46.64

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $50.07 to $55.43 depending on state and rural status.

StateNon-ruralRural
AK$50.07
AL$50.07
AR$50.07
AZ$50.07
CA$50.07
CO$50.07
CT$50.07
DC$50.07
DE$50.07
FL$50.07
GA$50.07
HI$50.07
IA$50.07
ID$50.07
IL$50.07
IN$50.07
KS$50.07
KY$50.07
LA$50.07
MA$50.07
MD$50.07
ME$50.07
MI$50.07
MN$50.07
MO$50.07
MS$50.07
MT$50.07
NC$50.07
ND$50.07
NE$50.07
NH$50.07
NJ$50.07
NM$50.07
NV$50.07
NY$50.07
OH$50.07
OK$50.07
OR$50.07
PA$50.07
PR$55.43
RI$50.07
SC$50.07
SD$50.07
TN$50.07
TX$50.07
UT$50.07
VA$50.07
VI$50.07
VT$50.07
WA$50.07
WI$50.07
WV$50.07
WY$50.07

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $47.32 to $56.68 depending on state and rural status.

Former-CBA payment limits: ceiling $47.32 · floor $40.22

StateNon-ruralRural
AK$47.32
AL$47.32
AR$47.32
AZ$47.32
CA$47.32
CO$47.32
CT$47.32
DC$47.32
DE$47.32
FL$47.32
GA$47.32
HI$47.32
IA$47.32
ID$47.32
IL$47.32
IN$47.32
KS$47.32
KY$47.32
LA$47.32
MA$47.32
MD$47.32
ME$47.32
MI$47.32
MN$47.32
MO$47.32
MS$47.32
MT$47.32
NC$47.32
ND$47.32
NE$47.32
NH$47.32
NJ$47.32
NM$47.32
NV$47.32
NY$47.32
OH$47.32
OK$47.32
OR$47.32
PA$47.32
PR$56.68
RI$47.32
SC$47.32
SD$47.32
TN$47.32
TX$47.32
UT$47.32
VA$47.32
VI$47.32
VT$47.32
WA$47.32
WI$47.32
WV$47.32
WY$47.32
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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