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E2627 — Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type

HCPCS Level II E-code · short descriptor: “Arm supp att to wc rancho ty”

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.

E2627 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $1160.59 to $2293.32 depending on state and rural status.

StateNon-ruralRural
AK$2210.63
AL$1189.35$1200.60
AR$1189.35$1200.60
AZ$1216.08$1372.34
CA$1189.55$1372.34
CO$1276.24$1372.34
CT$1325.65$1372.34
DC$1179.67$1372.34
DE$1179.67$1372.34
FL$1189.35$1372.34
GA$1189.35$1372.34
HI$2293.32
IA$1176.18$1372.34
ID$1276.24$1372.34
IL$1160.59$1200.60
IN$1160.59$1200.60
KS$1176.18$1200.60
KY$1189.35$1372.34
LA$1189.35$1200.60
MA$1325.65$1372.34
MD$1179.67$1200.60
ME$1325.65$1372.34
MI$1160.59$1372.34
MN$1176.18$1200.60
MO$1176.18$1200.60
MS$1189.35$1200.60
MT$1276.24$1372.34
NC$1189.35$1372.34
ND$1176.18$1200.60
NE$1176.18$1200.60
NH$1325.65$1372.34
NJ$1179.67$1372.34
NM$1216.08$1372.34
NV$1189.55$1372.34
NY$1179.67$1200.60
OH$1160.59$1200.60
OK$1216.08$1372.34
OR$1189.55$1372.34
PA$1179.67$1372.34
PR$1509.21
RI$1325.65$1372.34
SC$1189.35$1200.60
SD$1176.18$1200.60
TN$1189.35$1372.34
TX$1216.08$1372.34
UT$1276.24$1372.34
VA$1189.35$1200.60
VI$1200.60
VT$1325.65$1372.34
WA$1189.55$1372.34
WI$1160.59$1200.60
WV$1189.35$1200.60
WY$1200.60$1200.60

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $1200.62 to $2551.15 depending on state and rural status.

Former-CBA payment limits: ceiling $1412.49 · floor $1200.62

StateNon-ruralRural
AK$2385.76
AL$1200.62
AR$1200.62
AZ$1412.49
CA$1412.49
CO$1412.49
CT$1412.49
DC$1412.49
DE$1412.49
FL$1412.49
GA$1412.49
HI$2551.15
IA$1412.49
ID$1412.49
IL$1200.62
IN$1200.62
KS$1200.62
KY$1412.49
LA$1200.62
MA$1412.49
MD$1200.62
ME$1412.49
MI$1412.49
MN$1200.62
MO$1200.62
MS$1200.62
MT$1412.49
NC$1412.49
ND$1200.62
NE$1200.62
NH$1412.49
NJ$1412.49
NM$1412.49
NV$1412.49
NY$1200.62
OH$1200.62
OK$1412.49
OR$1412.49
PA$1412.49
PR$1509.23
RI$1412.49
SC$1200.62
SD$1200.62
TN$1412.49
TX$1412.49
UT$1412.49
VA$1200.62
VI$1200.62
VT$1412.49
WA$1412.49
WI$1200.62
WV$1200.62
WY$1200.62

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $116.06 to $229.33 depending on state and rural status.

StateNon-ruralRural
AK$221.07
AL$118.94$120.09
AR$118.94$120.09
AZ$121.61$137.25
CA$118.95$137.25
CO$127.63$137.25
CT$132.56$137.25
DC$117.97$137.25
DE$117.97$137.25
FL$118.94$137.25
GA$118.94$137.25
HI$229.33
IA$117.62$137.25
ID$127.63$137.25
IL$116.06$120.09
IN$116.06$120.09
KS$117.62$120.09
KY$118.94$137.25
LA$118.94$120.09
MA$132.56$137.25
MD$117.97$120.09
ME$132.56$137.25
MI$116.06$137.25
MN$117.62$120.09
MO$117.62$120.09
MS$118.94$120.09
MT$127.63$137.25
NC$118.94$137.25
ND$117.62$120.09
NE$117.62$120.09
NH$132.56$137.25
NJ$117.97$137.25
NM$121.61$137.25
NV$118.95$137.25
NY$117.97$120.09
OH$116.06$120.09
OK$121.61$137.25
OR$118.95$137.25
PA$117.97$137.25
PR$150.95
RI$132.56$137.25
SC$118.94$120.09
SD$117.62$120.09
TN$118.94$137.25
TX$121.61$137.25
UT$127.63$137.25
VA$118.94$120.09
VI$120.09
VT$132.56$137.25
WA$118.95$137.25
WI$116.06$120.09
WV$118.94$120.09
WY$120.09$120.09

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $120.11 to $255.14 depending on state and rural status.

Former-CBA payment limits: ceiling $141.30 · floor $120.11

StateNon-ruralRural
AK$238.59
AL$120.11
AR$120.11
AZ$141.30
CA$141.30
CO$141.30
CT$141.30
DC$141.30
DE$141.30
FL$141.30
GA$141.30
HI$255.14
IA$141.30
ID$141.30
IL$120.11
IN$120.11
KS$120.11
KY$141.30
LA$120.11
MA$141.30
MD$120.11
ME$141.30
MI$141.30
MN$120.11
MO$120.11
MS$120.11
MT$141.30
NC$141.30
ND$120.11
NE$120.11
NH$141.30
NJ$141.30
NM$141.30
NV$141.30
NY$120.11
OH$120.11
OK$141.30
OR$141.30
PA$141.30
PR$150.97
RI$141.30
SC$120.11
SD$120.11
TN$141.30
TX$141.30
UT$141.30
VA$120.11
VI$120.11
VT$141.30
WA$141.30
WI$120.11
WV$120.11
WY$120.11

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $870.44 to $1719.99 depending on state and rural status.

StateNon-ruralRural
AK$1657.98
AL$892.02$900.44
AR$892.02$900.44
AZ$912.06$1029.25
CA$892.17$1029.25
CO$957.18$1029.25
CT$994.23$1029.25
DC$884.76$1029.25
DE$884.76$1029.25
FL$892.02$1029.25
GA$892.02$1029.25
HI$1719.99
IA$882.13$1029.25
ID$957.18$1029.25
IL$870.44$900.44
IN$870.44$900.44
KS$882.13$900.44
KY$892.02$1029.25
LA$892.02$900.44
MA$994.23$1029.25
MD$884.76$900.44
ME$994.23$1029.25
MI$870.44$1029.25
MN$882.13$900.44
MO$882.13$900.44
MS$892.02$900.44
MT$957.18$1029.25
NC$892.02$1029.25
ND$882.13$900.44
NE$882.13$900.44
NH$994.23$1029.25
NJ$884.76$1029.25
NM$912.06$1029.25
NV$892.17$1029.25
NY$884.76$900.44
OH$870.44$900.44
OK$912.06$1029.25
OR$892.17$1029.25
PA$884.76$1029.25
PR$1131.88
RI$994.23$1029.25
SC$892.02$900.44
SD$882.13$900.44
TN$892.02$1029.25
TX$912.06$1029.25
UT$957.18$1029.25
VA$892.02$900.44
VI$900.44
VT$994.23$1029.25
WA$892.17$1029.25
WI$870.44$900.44
WV$892.02$900.44
WY$900.44$900.44

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $900.44 to $1913.34 depending on state and rural status.

Former-CBA payment limits: ceiling $1059.34 · floor $900.44

StateNon-ruralRural
AK$1789.36
AL$900.44
AR$900.44
AZ$1059.34
CA$1059.34
CO$1059.34
CT$1059.34
DC$1059.34
DE$1059.34
FL$1059.34
GA$1059.34
HI$1913.34
IA$1059.34
ID$1059.34
IL$900.44
IN$900.44
KS$900.44
KY$1059.34
LA$900.44
MA$1059.34
MD$900.44
ME$1059.34
MI$1059.34
MN$900.44
MO$900.44
MS$900.44
MT$1059.34
NC$1059.34
ND$900.44
NE$900.44
NH$1059.34
NJ$1059.34
NM$1059.34
NV$1059.34
NY$900.44
OH$900.44
OK$1059.34
OR$1059.34
PA$1059.34
PR$1131.90
RI$1059.34
SC$900.44
SD$900.44
TN$1059.34
TX$1059.34
UT$1059.34
VA$900.44
VI$900.44
VT$1059.34
WA$1059.34
WI$900.44
WV$900.44
WY$900.44
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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