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E2629 — Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)

HCPCS Level II E-code · short descriptor: “Friction dampening arm supp”

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.

E2629 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $1143.01 to $1492.97 depending on state and rural status.

StateNon-ruralRural
AK$1376.43
AL$1144.57$1144.57
AR$1173.01$1323.67
AZ$1175.48$1323.67
CA$1164.06$1323.67
CO$1143.01$1144.57
CT$1230.62$1323.67
DC$1193.19$1323.67
DE$1193.19$1323.67
FL$1173.01$1323.67
GA$1173.01$1323.67
HI$1426.74
IA$1162.19$1307.78
ID$1143.01$1323.67
IL$1223.28$1323.67
IN$1223.28$1299.43
KS$1144.57$1144.57
KY$1173.01$1304.82
LA$1173.01$1323.67
MA$1224.13$1224.13
MD$1193.19$1323.67
ME$1230.62$1285.33
MI$1144.57$1144.57
MN$1162.19$1303.79
MO$1144.57$1144.57
MS$1173.01$1323.67
MT$1143.01$1205.29
NC$1173.01$1323.67
ND$1144.57$1144.57
NE$1144.57$1144.57
NH$1230.62$1323.67
NJ$1193.19$1323.67
NM$1175.48$1247.77
NV$1164.06$1323.67
NY$1193.19$1323.67
OH$1223.28$1323.67
OK$1175.48$1299.43
OR$1164.06$1323.67
PA$1193.19$1323.67
PR$1492.97
RI$1230.62$1323.67
SC$1144.57$1144.57
SD$1144.57$1144.57
TN$1173.01$1323.67
TX$1175.48$1257.18
UT$1143.01$1144.57
VA$1173.01$1296.15
VI$1323.67
VT$1230.62$1323.67
WA$1164.06$1323.67
WI$1223.28$1299.43
WV$1173.01$1323.67
WY$1143.01$1144.57

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $1144.58 to $1685.17 depending on state and rural status.

Former-CBA payment limits: ceiling $1346.56 · floor $1144.58

StateNon-ruralRural
AK$1452.10
AL$1144.58
AR$1346.56
AZ$1346.56
CA$1346.56
CO$1144.58
CT$1346.56
DC$1346.56
DE$1346.56
FL$1346.56
GA$1346.56
HI$1552.71
IA$1314.79
ID$1346.56
IL$1346.56
IN$1299.45
KS$1144.58
KY$1308.85
LA$1346.56
MA$1224.15
MD$1346.56
ME$1285.35
MI$1144.58
MN$1306.83
MO$1144.58
MS$1346.56
MT$1205.30
NC$1346.56
ND$1144.58
NE$1144.58
NH$1346.56
NJ$1346.56
NM$1247.76
NV$1346.56
NY$1346.56
OH$1346.56
OK$1299.45
OR$1346.56
PA$1346.56
PR$1685.17
RI$1346.56
SC$1144.58
SD$1144.58
TN$1346.56
TX$1257.18
UT$1144.58
VA$1296.13
VI$1346.56
VT$1346.56
WA$1346.56
WI$1299.45
WV$1346.56
WY$1144.58

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $114.30 to $149.31 depending on state and rural status.

StateNon-ruralRural
AK$137.63
AL$114.44$114.44
AR$117.30$132.36
AZ$117.55$132.36
CA$116.41$132.36
CO$114.30$114.44
CT$123.06$132.36
DC$119.32$132.36
DE$119.32$132.36
FL$117.30$132.36
GA$117.30$132.36
HI$142.69
IA$116.22$130.77
ID$114.30$132.36
IL$122.33$132.36
IN$122.33$129.94
KS$114.44$114.44
KY$117.30$130.48
LA$117.30$132.36
MA$122.40$122.40
MD$119.32$132.36
ME$123.06$128.52
MI$114.44$114.44
MN$116.22$130.38
MO$114.44$114.44
MS$117.30$132.36
MT$114.30$120.58
NC$117.30$132.36
ND$114.44$114.44
NE$114.44$114.44
NH$123.06$132.36
NJ$119.32$132.36
NM$117.55$124.78
NV$116.41$132.36
NY$119.32$132.36
OH$122.33$132.36
OK$117.55$129.94
OR$116.41$132.36
PA$119.32$132.36
PR$149.31
RI$123.06$132.36
SC$114.44$114.44
SD$114.44$114.44
TN$117.30$132.36
TX$117.55$125.71
UT$114.30$114.44
VA$117.30$129.60
VI$132.36
VT$123.06$132.36
WA$116.41$132.36
WI$122.33$129.94
WV$117.30$132.36
WY$114.30$114.44

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $114.45 to $168.53 depending on state and rural status.

Former-CBA payment limits: ceiling $134.65 · floor $114.45

StateNon-ruralRural
AK$145.22
AL$114.45
AR$134.65
AZ$134.65
CA$134.65
CO$114.45
CT$134.65
DC$134.65
DE$134.65
FL$134.65
GA$134.65
HI$155.30
IA$131.47
ID$134.65
IL$134.65
IN$129.94
KS$114.45
KY$130.88
LA$134.65
MA$122.39
MD$134.65
ME$128.51
MI$114.45
MN$130.66
MO$114.45
MS$134.65
MT$120.58
NC$134.65
ND$114.45
NE$114.45
NH$134.65
NJ$134.65
NM$124.79
NV$134.65
NY$134.65
OH$134.65
OK$129.94
OR$134.65
PA$134.65
PR$168.53
RI$134.65
SC$114.45
SD$114.45
TN$134.65
TX$125.70
UT$114.45
VA$129.59
VI$134.65
VT$134.65
WA$134.65
WI$129.94
WV$134.65
WY$114.45

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $857.25 to $1119.72 depending on state and rural status.

StateNon-ruralRural
AK$1032.31
AL$858.43$858.43
AR$879.76$992.75
AZ$881.61$992.75
CA$873.05$992.75
CO$857.25$858.43
CT$922.97$992.75
DC$894.90$992.75
DE$894.90$992.75
FL$879.76$992.75
GA$879.76$992.75
HI$1070.06
IA$871.65$980.83
ID$857.25$992.75
IL$917.47$992.75
IN$917.47$974.59
KS$858.43$858.43
KY$879.76$978.61
LA$879.76$992.75
MA$918.11$918.11
MD$894.90$992.75
ME$922.97$963.96
MI$858.43$858.43
MN$871.65$977.84
MO$858.43$858.43
MS$879.76$992.75
MT$857.25$903.97
NC$879.76$992.75
ND$858.43$858.43
NE$858.43$858.43
NH$922.97$992.75
NJ$894.90$992.75
NM$881.61$935.81
NV$873.05$992.75
NY$894.90$992.75
OH$917.47$992.75
OK$881.61$974.59
OR$873.05$992.75
PA$894.90$992.75
PR$1119.72
RI$922.97$992.75
SC$858.43$858.43
SD$858.43$858.43
TN$879.76$992.75
TX$881.61$942.90
UT$857.25$858.43
VA$879.76$972.06
VI$992.75
VT$922.97$992.75
WA$873.05$992.75
WI$917.47$974.59
WV$879.76$992.75
WY$857.25$858.43

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $858.42 to $1263.85 depending on state and rural status.

Former-CBA payment limits: ceiling $1009.91 · floor $858.42

StateNon-ruralRural
AK$1089.04
AL$858.42
AR$1009.91
AZ$1009.91
CA$1009.91
CO$858.42
CT$1009.91
DC$1009.91
DE$1009.91
FL$1009.91
GA$1009.91
HI$1164.52
IA$986.09
ID$1009.91
IL$1009.91
IN$974.59
KS$858.42
KY$981.63
LA$1009.91
MA$918.14
MD$1009.91
ME$963.97
MI$858.42
MN$980.11
MO$858.42
MS$1009.91
MT$903.96
NC$1009.91
ND$858.42
NE$858.42
NH$1009.91
NJ$1009.91
NM$935.80
NV$1009.91
NY$1009.91
OH$1009.91
OK$974.59
OR$1009.91
PA$1009.91
PR$1263.85
RI$1009.91
SC$858.42
SD$858.42
TN$1009.91
TX$942.92
UT$858.42
VA$972.06
VI$1009.91
VT$1009.91
WA$1009.91
WI$974.59
WV$1009.91
WY$858.42
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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Related E-codes

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