MyMedi-AI

E2626 — Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable

HCPCS Level II E-code · short descriptor: “Seo mobile arm sup att to wc”

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.

E2626 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $750.55 to $1221.40 depending on state and rural status.

StateNon-ruralRural
AK$993.81
AL$768.67$847.48
AR$752.41$752.41
AZ$756.09$874.46
CA$750.55$874.46
CO$799.68$874.46
CT$842.75$874.46
DC$773.04$874.46
DE$773.04$874.46
FL$768.67$874.46
GA$768.67$874.46
HI$1030.99
IA$793.57$874.46
ID$799.68$874.46
IL$795.38$874.46
IN$752.41$752.41
KS$793.57$801.32
KY$768.67$874.46
LA$752.41$752.41
MA$842.75$874.46
MD$773.04$869.20
ME$842.75$874.46
MI$795.38$874.46
MN$793.57$874.46
MO$793.57$801.32
MS$768.67$874.46
MT$799.68$864.55
NC$768.67$874.46
ND$752.41$752.41
NE$793.57$801.32
NH$842.75$874.46
NJ$773.04$874.46
NM$756.09$862.27
NV$750.55$874.46
NY$773.04$874.46
OH$795.38$868.32
OK$756.09$874.46
OR$750.55$874.46
PA$773.04$874.46
PR$1221.40
RI$842.75$874.46
SC$752.41$752.41
SD$752.41$752.41
TN$768.67$874.46
TX$756.09$822.50
UT$799.68$874.46
VA$768.67$837.87
VI$885.19
VT$842.75$874.46
WA$750.55$874.46
WI$795.38$868.32
WV$768.67$868.32
WY$752.41$752.41

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $752.43 to $1527.73 depending on state and rural status.

Former-CBA payment limits: ceiling $885.21 · floor $752.43

StateNon-ruralRural
AK$1072.53
AL$847.46
AR$752.43
AZ$885.21
CA$885.21
CO$885.21
CT$885.21
DC$885.21
DE$885.21
FL$885.21
GA$885.21
HI$1146.92
IA$885.21
ID$885.21
IL$885.21
IN$752.43
KS$801.33
KY$885.21
LA$752.43
MA$885.21
MD$874.69
ME$885.21
MI$885.21
MN$885.21
MO$801.33
MS$885.21
MT$865.37
NC$885.21
ND$752.43
NE$801.33
NH$885.21
NJ$885.21
NM$862.27
NV$885.21
NY$885.21
OH$872.91
OK$885.21
OR$885.21
PA$885.21
PR$1527.73
RI$885.21
SC$752.43
SD$752.43
TN$885.21
TX$822.52
UT$885.21
VA$837.88
VI$885.21
VT$885.21
WA$885.21
WI$872.91
WV$872.91
WY$752.43

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $75.06 to $122.15 depending on state and rural status.

StateNon-ruralRural
AK$99.37
AL$76.87$84.78
AR$75.21$75.21
AZ$75.61$87.43
CA$75.06$87.43
CO$79.97$87.43
CT$84.28$87.43
DC$77.30$87.43
DE$77.30$87.43
FL$76.87$87.43
GA$76.87$87.43
HI$103.10
IA$79.36$87.43
ID$79.97$87.43
IL$79.54$87.43
IN$75.21$75.21
KS$79.36$80.12
KY$76.87$87.43
LA$75.21$75.21
MA$84.28$87.43
MD$77.30$86.93
ME$84.28$87.43
MI$79.54$87.43
MN$79.36$87.43
MO$79.36$80.12
MS$76.87$87.43
MT$79.97$86.46
NC$76.87$87.43
ND$75.21$75.21
NE$79.36$80.12
NH$84.28$87.43
NJ$77.30$87.43
NM$75.61$86.26
NV$75.06$87.43
NY$77.30$87.43
OH$79.54$86.84
OK$75.61$87.43
OR$75.06$87.43
PA$77.30$87.43
PR$122.15
RI$84.28$87.43
SC$75.21$75.21
SD$75.21$75.21
TN$76.87$87.43
TX$75.61$82.28
UT$79.97$87.43
VA$76.87$83.82
VI$88.49
VT$84.28$87.43
WA$75.06$87.43
WI$79.54$86.84
WV$76.87$86.84
WY$75.21$75.21

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $75.22 to $152.79 depending on state and rural status.

Former-CBA payment limits: ceiling $88.49 · floor $75.22

StateNon-ruralRural
AK$107.22
AL$84.79
AR$75.22
AZ$88.49
CA$88.49
CO$88.49
CT$88.49
DC$88.49
DE$88.49
FL$88.49
GA$88.49
HI$114.69
IA$88.49
ID$88.49
IL$88.49
IN$75.22
KS$80.12
KY$88.49
LA$75.22
MA$88.49
MD$87.48
ME$88.49
MI$88.49
MN$88.49
MO$80.12
MS$88.49
MT$86.53
NC$88.49
ND$75.22
NE$80.12
NH$88.49
NJ$88.49
NM$86.25
NV$88.49
NY$88.49
OH$87.30
OK$88.49
OR$88.49
PA$88.49
PR$152.79
RI$88.49
SC$75.22
SD$75.22
TN$88.49
TX$82.27
UT$88.49
VA$83.82
VI$88.49
VT$88.49
WA$88.49
WI$87.30
WV$87.30
WY$75.22

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $562.92 to $916.06 depending on state and rural status.

StateNon-ruralRural
AK$745.35
AL$576.50$635.61
AR$564.25$564.25
AZ$567.07$655.81
CA$562.92$655.81
CO$599.76$655.81
CT$632.06$655.81
DC$579.78$655.81
DE$579.78$655.81
FL$576.50$655.81
GA$576.50$655.81
HI$773.23
IA$595.18$655.81
ID$599.76$655.81
IL$596.54$655.81
IN$564.25$564.25
KS$595.18$601.02
KY$576.50$655.81
LA$564.25$564.25
MA$632.06$655.81
MD$579.78$651.89
ME$632.06$655.81
MI$596.54$655.81
MN$595.18$655.81
MO$595.18$601.02
MS$576.50$655.81
MT$599.76$648.42
NC$576.50$655.81
ND$564.25$564.25
NE$595.18$601.02
NH$632.06$655.81
NJ$579.78$655.81
NM$567.07$646.70
NV$562.92$655.81
NY$579.78$655.81
OH$596.54$651.22
OK$567.07$655.81
OR$562.92$655.81
PA$579.78$655.81
PR$916.06
RI$632.06$655.81
SC$564.25$564.25
SD$564.25$564.25
TN$576.50$655.81
TX$567.07$616.92
UT$599.76$655.81
VA$576.50$628.42
VI$663.82
VT$632.06$655.81
WA$562.92$655.81
WI$596.54$651.22
WV$576.50$651.22
WY$564.25$564.25

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $564.25 to $1145.82 depending on state and rural status.

Former-CBA payment limits: ceiling $663.82 · floor $564.25

StateNon-ruralRural
AK$804.38
AL$635.62
AR$564.25
AZ$663.82
CA$663.82
CO$663.82
CT$663.82
DC$663.82
DE$663.82
FL$663.82
GA$663.82
HI$860.14
IA$663.82
ID$663.82
IL$663.82
IN$564.25
KS$601.02
KY$663.82
LA$564.25
MA$663.82
MD$655.99
ME$663.82
MI$663.82
MN$663.82
MO$601.02
MS$663.82
MT$649.04
NC$663.82
ND$564.25
NE$601.02
NH$663.82
NJ$663.82
NM$646.71
NV$663.82
NY$663.82
OH$654.64
OK$663.82
OR$663.82
PA$663.82
PR$1145.82
RI$663.82
SC$564.25
SD$564.25
TN$663.82
TX$616.95
UT$663.82
VA$628.41
VI$663.82
VT$663.82
WA$663.82
WI$654.64
WV$654.64
WY$564.25
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.

Common denial codes to watch

Related E-codes

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