E2623 — Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth
HCPCS Level II E-code · short descriptor: “Adj skin pro 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.
E2623 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $491.60 to $556.65 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $504.84 | — |
| AL | $491.60 | $504.84 |
| AR | $491.60 | $504.84 |
| AZ | $491.60 | $504.84 |
| CA | $491.60 | $504.84 |
| CO | $491.60 | $504.84 |
| CT | $491.60 | $504.84 |
| DC | $491.60 | $504.84 |
| DE | $491.60 | $504.84 |
| FL | $491.60 | $504.84 |
| GA | $491.60 | $504.84 |
| HI | $504.84 | — |
| IA | $491.60 | $504.84 |
| ID | $491.60 | $504.84 |
| IL | $491.60 | $504.84 |
| IN | $491.60 | $504.84 |
| KS | $491.60 | $504.84 |
| KY | $491.60 | $504.84 |
| LA | $491.60 | $504.84 |
| MA | $491.60 | $504.84 |
| MD | $491.60 | $504.84 |
| ME | $491.60 | $504.84 |
| MI | $491.60 | $504.84 |
| MN | $491.60 | $504.84 |
| MO | $491.60 | $504.84 |
| MS | $491.60 | $504.84 |
| MT | $491.60 | $504.84 |
| NC | $491.60 | $504.84 |
| ND | $491.60 | $504.84 |
| NE | $491.60 | $504.84 |
| NH | $491.60 | $504.84 |
| NJ | $491.60 | $504.84 |
| NM | $491.60 | $504.84 |
| NV | $491.60 | $504.84 |
| NY | $491.60 | $504.84 |
| OH | $491.60 | $504.84 |
| OK | $491.60 | $504.84 |
| OR | $491.60 | $504.84 |
| PA | $491.60 | $504.84 |
| PR | $556.65 | — |
| RI | $491.60 | $504.84 |
| SC | $491.60 | $504.84 |
| SD | $491.60 | $504.84 |
| TN | $491.60 | $504.84 |
| TX | $491.60 | $504.84 |
| UT | $491.60 | $504.84 |
| VA | $491.60 | $504.84 |
| VI | $504.84 | — |
| VT | $491.60 | $504.84 |
| WA | $491.60 | $504.84 |
| WI | $491.60 | $504.84 |
| WV | $491.60 | $504.84 |
| WY | $491.60 | $504.84 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $542.40 to $601.72 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $542.40 | — |
| AL | — | $542.40 |
| AR | — | $542.40 |
| AZ | — | $542.40 |
| CA | — | $542.40 |
| CO | — | $542.40 |
| CT | — | $542.40 |
| DC | — | $542.40 |
| DE | — | $542.40 |
| FL | — | $542.40 |
| GA | — | $542.40 |
| HI | $542.40 | — |
| IA | — | $542.40 |
| ID | — | $542.40 |
| IL | — | $542.40 |
| IN | — | $542.40 |
| KS | — | $542.40 |
| KY | — | $542.40 |
| LA | — | $542.40 |
| MA | — | $542.40 |
| MD | — | $542.40 |
| ME | — | $542.40 |
| MI | — | $542.40 |
| MN | — | $542.40 |
| MO | — | $542.40 |
| MS | — | $542.40 |
| MT | — | $542.40 |
| NC | — | $542.40 |
| ND | — | $542.40 |
| NE | — | $542.40 |
| NH | — | $542.40 |
| NJ | — | $542.40 |
| NM | — | $542.40 |
| NV | — | $542.40 |
| NY | — | $542.40 |
| OH | — | $542.40 |
| OK | — | $542.40 |
| OR | — | $542.40 |
| PA | — | $542.40 |
| PR | $601.72 | — |
| RI | — | $542.40 |
| SC | — | $542.40 |
| SD | — | $542.40 |
| TN | — | $542.40 |
| TX | — | $542.40 |
| UT | — | $542.40 |
| VA | — | $542.40 |
| VI | $542.40 | — |
| VT | — | $542.40 |
| WA | — | $542.40 |
| WI | — | $542.40 |
| WV | — | $542.40 |
| WY | — | $542.40 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $518.07 to $621.69 depending on state and rural status.
Former-CBA payment limits: ceiling $518.07 · floor $440.36
| State | Non-rural | Rural |
|---|---|---|
| AK | $518.07 | — |
| AL | $518.07 | — |
| AR | $518.07 | — |
| AZ | $518.07 | — |
| CA | $518.07 | — |
| CO | $518.07 | — |
| CT | $518.07 | — |
| DC | $518.07 | — |
| DE | $518.07 | — |
| FL | $518.07 | — |
| GA | $518.07 | — |
| HI | $518.07 | — |
| IA | $518.07 | — |
| ID | $518.07 | — |
| IL | $518.07 | — |
| IN | $518.07 | — |
| KS | $518.07 | — |
| KY | $518.07 | — |
| LA | $518.07 | — |
| MA | $518.07 | — |
| MD | $518.07 | — |
| ME | $518.07 | — |
| MI | $518.07 | — |
| MN | $518.07 | — |
| MO | $518.07 | — |
| MS | $518.07 | — |
| MT | $518.07 | — |
| NC | $518.07 | — |
| ND | $518.07 | — |
| NE | $518.07 | — |
| NH | $518.07 | — |
| NJ | $518.07 | — |
| NM | $518.07 | — |
| NV | $518.07 | — |
| NY | $518.07 | — |
| OH | $518.07 | — |
| OK | $518.07 | — |
| OR | $518.07 | — |
| PA | $518.07 | — |
| PR | $621.69 | — |
| RI | $518.07 | — |
| SC | $518.07 | — |
| SD | $518.07 | — |
| TN | $518.07 | — |
| TX | $518.07 | — |
| UT | $518.07 | — |
| VA | $518.07 | — |
| VI | $518.07 | — |
| VT | $518.07 | — |
| WA | $518.07 | — |
| WI | $518.07 | — |
| WV | $518.07 | — |
| WY | $518.07 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $49.16 to $55.66 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $50.49 | — |
| AL | $49.16 | $50.49 |
| AR | $49.16 | $50.49 |
| AZ | $49.16 | $50.49 |
| CA | $49.16 | $50.49 |
| CO | $49.16 | $50.49 |
| CT | $49.16 | $50.49 |
| DC | $49.16 | $50.49 |
| DE | $49.16 | $50.49 |
| FL | $49.16 | $50.49 |
| GA | $49.16 | $50.49 |
| HI | $50.49 | — |
| IA | $49.16 | $50.49 |
| ID | $49.16 | $50.49 |
| IL | $49.16 | $50.49 |
| IN | $49.16 | $50.49 |
| KS | $49.16 | $50.49 |
| KY | $49.16 | $50.49 |
| LA | $49.16 | $50.49 |
| MA | $49.16 | $50.49 |
| MD | $49.16 | $50.49 |
| ME | $49.16 | $50.49 |
| MI | $49.16 | $50.49 |
| MN | $49.16 | $50.49 |
| MO | $49.16 | $50.49 |
| MS | $49.16 | $50.49 |
| MT | $49.16 | $50.49 |
| NC | $49.16 | $50.49 |
| ND | $49.16 | $50.49 |
| NE | $49.16 | $50.49 |
| NH | $49.16 | $50.49 |
| NJ | $49.16 | $50.49 |
| NM | $49.16 | $50.49 |
| NV | $49.16 | $50.49 |
| NY | $49.16 | $50.49 |
| OH | $49.16 | $50.49 |
| OK | $49.16 | $50.49 |
| OR | $49.16 | $50.49 |
| PA | $49.16 | $50.49 |
| PR | $55.66 | — |
| RI | $49.16 | $50.49 |
| SC | $49.16 | $50.49 |
| SD | $49.16 | $50.49 |
| TN | $49.16 | $50.49 |
| TX | $49.16 | $50.49 |
| UT | $49.16 | $50.49 |
| VA | $49.16 | $50.49 |
| VI | $50.49 | — |
| VT | $49.16 | $50.49 |
| WA | $49.16 | $50.49 |
| WI | $49.16 | $50.49 |
| WV | $49.16 | $50.49 |
| WY | $49.16 | $50.49 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $54.25 to $60.16 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $54.25 | — |
| AL | — | $54.25 |
| AR | — | $54.25 |
| AZ | — | $54.25 |
| CA | — | $54.25 |
| CO | — | $54.25 |
| CT | — | $54.25 |
| DC | — | $54.25 |
| DE | — | $54.25 |
| FL | — | $54.25 |
| GA | — | $54.25 |
| HI | $54.25 | — |
| IA | — | $54.25 |
| ID | — | $54.25 |
| IL | — | $54.25 |
| IN | — | $54.25 |
| KS | — | $54.25 |
| KY | — | $54.25 |
| LA | — | $54.25 |
| MA | — | $54.25 |
| MD | — | $54.25 |
| ME | — | $54.25 |
| MI | — | $54.25 |
| MN | — | $54.25 |
| MO | — | $54.25 |
| MS | — | $54.25 |
| MT | — | $54.25 |
| NC | — | $54.25 |
| ND | — | $54.25 |
| NE | — | $54.25 |
| NH | — | $54.25 |
| NJ | — | $54.25 |
| NM | — | $54.25 |
| NV | — | $54.25 |
| NY | — | $54.25 |
| OH | — | $54.25 |
| OK | — | $54.25 |
| OR | — | $54.25 |
| PA | — | $54.25 |
| PR | $60.16 | — |
| RI | — | $54.25 |
| SC | — | $54.25 |
| SD | — | $54.25 |
| TN | — | $54.25 |
| TX | — | $54.25 |
| UT | — | $54.25 |
| VA | — | $54.25 |
| VI | $54.25 | — |
| VT | — | $54.25 |
| WA | — | $54.25 |
| WI | — | $54.25 |
| WV | — | $54.25 |
| WY | — | $54.25 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $51.83 to $62.16 depending on state and rural status.
Former-CBA payment limits: ceiling $51.83 · floor $44.06
| State | Non-rural | Rural |
|---|---|---|
| AK | $51.83 | — |
| AL | $51.83 | — |
| AR | $51.83 | — |
| AZ | $51.83 | — |
| CA | $51.83 | — |
| CO | $51.83 | — |
| CT | $51.83 | — |
| DC | $51.83 | — |
| DE | $51.83 | — |
| FL | $51.83 | — |
| GA | $51.83 | — |
| HI | $51.83 | — |
| IA | $51.83 | — |
| ID | $51.83 | — |
| IL | $51.83 | — |
| IN | $51.83 | — |
| KS | $51.83 | — |
| KY | $51.83 | — |
| LA | $51.83 | — |
| MA | $51.83 | — |
| MD | $51.83 | — |
| ME | $51.83 | — |
| MI | $51.83 | — |
| MN | $51.83 | — |
| MO | $51.83 | — |
| MS | $51.83 | — |
| MT | $51.83 | — |
| NC | $51.83 | — |
| ND | $51.83 | — |
| NE | $51.83 | — |
| NH | $51.83 | — |
| NJ | $51.83 | — |
| NM | $51.83 | — |
| NV | $51.83 | — |
| NY | $51.83 | — |
| OH | $51.83 | — |
| OK | $51.83 | — |
| OR | $51.83 | — |
| PA | $51.83 | — |
| PR | $62.16 | — |
| RI | $51.83 | — |
| SC | $51.83 | — |
| SD | $51.83 | — |
| TN | $51.83 | — |
| TX | $51.83 | — |
| UT | $51.83 | — |
| VA | $51.83 | — |
| VI | $51.83 | — |
| VT | $51.83 | — |
| WA | $51.83 | — |
| WI | $51.83 | — |
| WV | $51.83 | — |
| WY | $51.83 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $368.70 to $417.49 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $378.62 | — |
| AL | $368.70 | $378.62 |
| AR | $368.70 | $378.62 |
| AZ | $368.70 | $378.62 |
| CA | $368.70 | $378.62 |
| CO | $368.70 | $378.62 |
| CT | $368.70 | $378.62 |
| DC | $368.70 | $378.62 |
| DE | $368.70 | $378.62 |
| FL | $368.70 | $378.62 |
| GA | $368.70 | $378.62 |
| HI | $378.62 | — |
| IA | $368.70 | $378.62 |
| ID | $368.70 | $378.62 |
| IL | $368.70 | $378.62 |
| IN | $368.70 | $378.62 |
| KS | $368.70 | $378.62 |
| KY | $368.70 | $378.62 |
| LA | $368.70 | $378.62 |
| MA | $368.70 | $378.62 |
| MD | $368.70 | $378.62 |
| ME | $368.70 | $378.62 |
| MI | $368.70 | $378.62 |
| MN | $368.70 | $378.62 |
| MO | $368.70 | $378.62 |
| MS | $368.70 | $378.62 |
| MT | $368.70 | $378.62 |
| NC | $368.70 | $378.62 |
| ND | $368.70 | $378.62 |
| NE | $368.70 | $378.62 |
| NH | $368.70 | $378.62 |
| NJ | $368.70 | $378.62 |
| NM | $368.70 | $378.62 |
| NV | $368.70 | $378.62 |
| NY | $368.70 | $378.62 |
| OH | $368.70 | $378.62 |
| OK | $368.70 | $378.62 |
| OR | $368.70 | $378.62 |
| PA | $368.70 | $378.62 |
| PR | $417.49 | — |
| RI | $368.70 | $378.62 |
| SC | $368.70 | $378.62 |
| SD | $368.70 | $378.62 |
| TN | $368.70 | $378.62 |
| TX | $368.70 | $378.62 |
| UT | $368.70 | $378.62 |
| VA | $368.70 | $378.62 |
| VI | $378.62 | — |
| VT | $368.70 | $378.62 |
| WA | $368.70 | $378.62 |
| WI | $368.70 | $378.62 |
| WV | $368.70 | $378.62 |
| WY | $368.70 | $378.62 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $406.79 to $451.30 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $406.79 | — |
| AL | — | $406.79 |
| AR | — | $406.79 |
| AZ | — | $406.79 |
| CA | — | $406.79 |
| CO | — | $406.79 |
| CT | — | $406.79 |
| DC | — | $406.79 |
| DE | — | $406.79 |
| FL | — | $406.79 |
| GA | — | $406.79 |
| HI | $406.79 | — |
| IA | — | $406.79 |
| ID | — | $406.79 |
| IL | — | $406.79 |
| IN | — | $406.79 |
| KS | — | $406.79 |
| KY | — | $406.79 |
| LA | — | $406.79 |
| MA | — | $406.79 |
| MD | — | $406.79 |
| ME | — | $406.79 |
| MI | — | $406.79 |
| MN | — | $406.79 |
| MO | — | $406.79 |
| MS | — | $406.79 |
| MT | — | $406.79 |
| NC | — | $406.79 |
| ND | — | $406.79 |
| NE | — | $406.79 |
| NH | — | $406.79 |
| NJ | — | $406.79 |
| NM | — | $406.79 |
| NV | — | $406.79 |
| NY | — | $406.79 |
| OH | — | $406.79 |
| OK | — | $406.79 |
| OR | — | $406.79 |
| PA | — | $406.79 |
| PR | $451.30 | — |
| RI | — | $406.79 |
| SC | — | $406.79 |
| SD | — | $406.79 |
| TN | — | $406.79 |
| TX | — | $406.79 |
| UT | — | $406.79 |
| VA | — | $406.79 |
| VI | $406.79 | — |
| VT | — | $406.79 |
| WA | — | $406.79 |
| WI | — | $406.79 |
| WV | — | $406.79 |
| WY | — | $406.79 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $388.56 to $466.28 depending on state and rural status.
Former-CBA payment limits: ceiling $388.56 · floor $330.28
| State | Non-rural | Rural |
|---|---|---|
| AK | $388.56 | — |
| AL | $388.56 | — |
| AR | $388.56 | — |
| AZ | $388.56 | — |
| CA | $388.56 | — |
| CO | $388.56 | — |
| CT | $388.56 | — |
| DC | $388.56 | — |
| DE | $388.56 | — |
| FL | $388.56 | — |
| GA | $388.56 | — |
| HI | $388.56 | — |
| IA | $388.56 | — |
| ID | $388.56 | — |
| IL | $388.56 | — |
| IN | $388.56 | — |
| KS | $388.56 | — |
| KY | $388.56 | — |
| LA | $388.56 | — |
| MA | $388.56 | — |
| MD | $388.56 | — |
| ME | $388.56 | — |
| MI | $388.56 | — |
| MN | $388.56 | — |
| MO | $388.56 | — |
| MS | $388.56 | — |
| MT | $388.56 | — |
| NC | $388.56 | — |
| ND | $388.56 | — |
| NE | $388.56 | — |
| NH | $388.56 | — |
| NJ | $388.56 | — |
| NM | $388.56 | — |
| NV | $388.56 | — |
| NY | $388.56 | — |
| OH | $388.56 | — |
| OK | $388.56 | — |
| OR | $388.56 | — |
| PA | $388.56 | — |
| PR | $466.28 | — |
| RI | $388.56 | — |
| SC | $388.56 | — |
| SD | $388.56 | — |
| TN | $388.56 | — |
| TX | $388.56 | — |
| UT | $388.56 | — |
| VA | $388.56 | — |
| VI | $388.56 | — |
| VT | $388.56 | — |
| WA | $388.56 | — |
| WI | $388.56 | — |
| WV | $388.56 | — |
| WY | $388.56 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2623 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
Bill E2623 with confidence
Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →
Building an AI agent? Try the agent API in the playground — free PA-required lookups, E2623 included, and starter credits via POST /bot-marketplace/register.