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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
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.

E2623 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $491.60 to $556.65 depending on state and rural status.

StateNon-ruralRural
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.

StateNon-ruralRural
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

StateNon-ruralRural
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.

StateNon-ruralRural
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.

StateNon-ruralRural
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

StateNon-ruralRural
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.

StateNon-ruralRural
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.

StateNon-ruralRural
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

StateNon-ruralRural
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
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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