E2630 — Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support
HCPCS Level II E-code · short descriptor: “Monosuspension arm/hand 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
- Face-to-face & WOPD
- Not on the required list
- MUE unit limit
- 2
- 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 2026-10-25; 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 2026-10-25; 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.
E2630 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $781.26 to $1200.41 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $1157.10 | — |
| AL | $790.78 | $912.54 |
| AR | $790.78 | $800.39 |
| AZ | $814.82 | $912.54 |
| CA | $781.26 | $912.54 |
| CO | $815.88 | $912.54 |
| CT | $856.15 | $912.54 |
| DC | $785.41 | $899.81 |
| DE | $785.41 | $899.81 |
| FL | $790.78 | $912.54 |
| GA | $790.78 | $912.54 |
| HI | $1200.41 | — |
| IA | $787.88 | $912.54 |
| ID | $815.88 | $912.54 |
| IL | $807.10 | $912.54 |
| IN | $807.10 | $912.54 |
| KS | $787.88 | $800.39 |
| KY | $790.78 | $912.54 |
| LA | $790.78 | $912.54 |
| MA | $856.15 | $912.54 |
| MD | $785.41 | $912.54 |
| ME | $856.15 | $872.31 |
| MI | $807.10 | $912.54 |
| MN | $787.88 | $855.53 |
| MO | $787.88 | $800.39 |
| MS | $790.78 | $912.54 |
| MT | $815.88 | $912.54 |
| NC | $790.78 | $800.39 |
| ND | $787.88 | $800.39 |
| NE | $787.88 | $800.39 |
| NH | $856.15 | $912.54 |
| NJ | $785.41 | $899.81 |
| NM | $814.82 | $912.54 |
| NV | $781.26 | $912.54 |
| NY | $785.41 | $850.40 |
| OH | $800.39 | $800.39 |
| OK | $814.82 | $912.54 |
| OR | $781.26 | $912.54 |
| PA | $785.41 | $899.81 |
| PR | $1069.75 | — |
| RI | $856.15 | $899.93 |
| SC | $790.78 | $912.54 |
| SD | $787.88 | $800.39 |
| TN | $790.78 | $800.39 |
| TX | $814.82 | $912.54 |
| UT | $815.88 | $912.54 |
| VA | $790.78 | $800.39 |
| VI | $872.42 | — |
| VT | $822.62 | $822.62 |
| WA | $781.26 | $912.54 |
| WI | $807.10 | $912.54 |
| WV | $790.78 | $800.39 |
| WY | $800.39 | $800.39 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $800.41 to $1335.36 depending on state and rural status.
Former-CBA payment limits: ceiling $941.66 · floor $800.41
| State | Non-rural | Rural |
|---|---|---|
| AK | $1248.77 | — |
| AL | $941.66 | — |
| AR | $800.41 | — |
| AZ | $941.66 | — |
| CA | $941.66 | — |
| CO | $941.66 | — |
| CT | $941.66 | — |
| DC | $916.18 | — |
| DE | $916.18 | — |
| FL | $941.66 | — |
| GA | $941.66 | — |
| HI | $1335.36 | — |
| IA | $941.66 | — |
| ID | $941.66 | — |
| IL | $941.66 | — |
| IN | $941.66 | — |
| KS | $800.41 | — |
| KY | $941.66 | — |
| LA | $941.66 | — |
| MA | $941.66 | — |
| MD | $941.66 | — |
| ME | $872.30 | — |
| MI | $941.66 | — |
| MN | $855.54 | — |
| MO | $800.41 | — |
| MS | $941.66 | — |
| MT | $941.66 | — |
| NC | $800.41 | — |
| ND | $800.41 | — |
| NE | $800.41 | — |
| NH | $941.66 | — |
| NJ | $916.18 | — |
| NM | $941.66 | — |
| NV | $941.66 | — |
| NY | $850.43 | — |
| OH | $800.41 | — |
| OK | $941.66 | — |
| OR | $941.66 | — |
| PA | $916.18 | — |
| PR | $1074.05 | — |
| RI | $916.42 | — |
| SC | $941.66 | — |
| SD | $800.41 | — |
| TN | $800.41 | — |
| TX | $941.66 | — |
| UT | $941.66 | — |
| VA | $800.41 | — |
| VI | $872.44 | — |
| VT | $822.63 | — |
| WA | $941.66 | — |
| WI | $941.66 | — |
| WV | $800.41 | — |
| WY | $800.41 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $78.12 to $120.04 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $115.72 | — |
| AL | $79.08 | $91.26 |
| AR | $79.08 | $80.04 |
| AZ | $81.48 | $91.26 |
| CA | $78.12 | $91.26 |
| CO | $81.59 | $91.26 |
| CT | $85.61 | $91.26 |
| DC | $78.54 | $89.99 |
| DE | $78.54 | $89.99 |
| FL | $79.08 | $91.26 |
| GA | $79.08 | $91.26 |
| HI | $120.04 | — |
| IA | $78.79 | $91.26 |
| ID | $81.59 | $91.26 |
| IL | $80.71 | $91.26 |
| IN | $80.71 | $91.26 |
| KS | $78.79 | $80.04 |
| KY | $79.08 | $91.26 |
| LA | $79.08 | $91.26 |
| MA | $85.61 | $91.26 |
| MD | $78.54 | $91.26 |
| ME | $85.61 | $87.24 |
| MI | $80.71 | $91.26 |
| MN | $78.79 | $85.55 |
| MO | $78.79 | $80.04 |
| MS | $79.08 | $91.26 |
| MT | $81.59 | $91.26 |
| NC | $79.08 | $80.04 |
| ND | $78.79 | $80.04 |
| NE | $78.79 | $80.04 |
| NH | $85.61 | $91.26 |
| NJ | $78.54 | $89.99 |
| NM | $81.48 | $91.26 |
| NV | $78.12 | $91.26 |
| NY | $78.54 | $85.04 |
| OH | $80.04 | $80.04 |
| OK | $81.48 | $91.26 |
| OR | $78.12 | $91.26 |
| PA | $78.54 | $89.99 |
| PR | $106.99 | — |
| RI | $85.61 | $90.00 |
| SC | $79.08 | $91.26 |
| SD | $78.79 | $80.04 |
| TN | $79.08 | $80.04 |
| TX | $81.48 | $91.26 |
| UT | $81.59 | $91.26 |
| VA | $79.08 | $80.04 |
| VI | $87.24 | — |
| VT | $82.28 | $82.28 |
| WA | $78.12 | $91.26 |
| WI | $80.71 | $91.26 |
| WV | $79.08 | $80.04 |
| WY | $80.04 | $80.04 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $80.03 to $133.55 depending on state and rural status.
Former-CBA payment limits: ceiling $94.15 · floor $80.03
| State | Non-rural | Rural |
|---|---|---|
| AK | $124.90 | — |
| AL | $94.15 | — |
| AR | $80.03 | — |
| AZ | $94.15 | — |
| CA | $94.15 | — |
| CO | $94.15 | — |
| CT | $94.15 | — |
| DC | $91.64 | — |
| DE | $91.64 | — |
| FL | $94.15 | — |
| GA | $94.15 | — |
| HI | $133.55 | — |
| IA | $94.15 | — |
| ID | $94.15 | — |
| IL | $94.15 | — |
| IN | $94.15 | — |
| KS | $80.03 | — |
| KY | $94.15 | — |
| LA | $94.15 | — |
| MA | $94.15 | — |
| MD | $94.15 | — |
| ME | $87.22 | — |
| MI | $94.15 | — |
| MN | $85.55 | — |
| MO | $80.03 | — |
| MS | $94.15 | — |
| MT | $94.15 | — |
| NC | $80.03 | — |
| ND | $80.03 | — |
| NE | $80.03 | — |
| NH | $94.15 | — |
| NJ | $91.64 | — |
| NM | $94.15 | — |
| NV | $94.15 | — |
| NY | $85.03 | — |
| OH | $80.03 | — |
| OK | $94.15 | — |
| OR | $94.15 | — |
| PA | $91.64 | — |
| PR | $107.45 | — |
| RI | $91.66 | — |
| SC | $94.15 | — |
| SD | $80.03 | — |
| TN | $80.03 | — |
| TX | $94.15 | — |
| UT | $94.15 | — |
| VA | $80.03 | — |
| VI | $87.22 | — |
| VT | $82.27 | — |
| WA | $94.15 | — |
| WI | $94.15 | — |
| WV | $80.03 | — |
| WY | $80.03 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $585.94 to $900.31 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $867.84 | — |
| AL | $593.09 | $684.40 |
| AR | $593.09 | $600.29 |
| AZ | $611.12 | $684.40 |
| CA | $585.94 | $684.40 |
| CO | $611.91 | $684.40 |
| CT | $642.12 | $684.40 |
| DC | $589.06 | $674.87 |
| DE | $589.06 | $674.87 |
| FL | $593.09 | $684.40 |
| GA | $593.09 | $684.40 |
| HI | $900.31 | — |
| IA | $590.92 | $684.40 |
| ID | $611.91 | $684.40 |
| IL | $605.33 | $684.40 |
| IN | $605.33 | $684.40 |
| KS | $590.92 | $600.29 |
| KY | $593.09 | $684.40 |
| LA | $593.09 | $684.40 |
| MA | $642.12 | $684.40 |
| MD | $589.06 | $684.40 |
| ME | $642.12 | $654.24 |
| MI | $605.33 | $684.40 |
| MN | $590.92 | $641.61 |
| MO | $590.92 | $600.29 |
| MS | $593.09 | $684.40 |
| MT | $611.91 | $684.40 |
| NC | $593.09 | $600.29 |
| ND | $590.92 | $600.29 |
| NE | $590.92 | $600.29 |
| NH | $642.12 | $684.40 |
| NJ | $589.06 | $674.87 |
| NM | $611.12 | $684.40 |
| NV | $585.94 | $684.40 |
| NY | $589.06 | $637.82 |
| OH | $600.29 | $600.29 |
| OK | $611.12 | $684.40 |
| OR | $585.94 | $684.40 |
| PA | $589.06 | $674.87 |
| PR | $802.32 | — |
| RI | $642.12 | $674.92 |
| SC | $593.09 | $684.40 |
| SD | $590.92 | $600.29 |
| TN | $593.09 | $600.29 |
| TX | $611.12 | $684.40 |
| UT | $611.91 | $684.40 |
| VA | $593.09 | $600.29 |
| VI | $654.34 | — |
| VT | $616.98 | $616.98 |
| WA | $585.94 | $684.40 |
| WI | $605.33 | $684.40 |
| WV | $593.09 | $600.29 |
| WY | $600.29 | $600.29 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $600.30 to $1001.52 depending on state and rural status.
Former-CBA payment limits: ceiling $706.24 · floor $600.30
| State | Non-rural | Rural |
|---|---|---|
| AK | $936.59 | — |
| AL | $706.24 | — |
| AR | $600.30 | — |
| AZ | $706.24 | — |
| CA | $706.24 | — |
| CO | $706.24 | — |
| CT | $706.24 | — |
| DC | $687.16 | — |
| DE | $687.16 | — |
| FL | $706.24 | — |
| GA | $706.24 | — |
| HI | $1001.52 | — |
| IA | $706.24 | — |
| ID | $706.24 | — |
| IL | $706.24 | — |
| IN | $706.24 | — |
| KS | $600.30 | — |
| KY | $706.24 | — |
| LA | $706.24 | — |
| MA | $706.24 | — |
| MD | $706.24 | — |
| ME | $654.23 | — |
| MI | $706.24 | — |
| MN | $641.61 | — |
| MO | $600.30 | — |
| MS | $706.24 | — |
| MT | $706.24 | — |
| NC | $600.30 | — |
| ND | $600.30 | — |
| NE | $600.30 | — |
| NH | $706.24 | — |
| NJ | $687.16 | — |
| NM | $706.24 | — |
| NV | $706.24 | — |
| NY | $637.83 | — |
| OH | $600.30 | — |
| OK | $706.24 | — |
| OR | $706.24 | — |
| PA | $687.16 | — |
| PR | $805.53 | — |
| RI | $687.27 | — |
| SC | $706.24 | — |
| SD | $600.30 | — |
| TN | $600.30 | — |
| TX | $706.24 | — |
| UT | $706.24 | — |
| VA | $600.30 | — |
| VI | $654.36 | — |
| VT | $617.00 | — |
| WA | $706.24 | — |
| WI | $706.24 | — |
| WV | $600.30 | — |
| WY | $600.30 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps E2630 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.
Common denial codes to watch
Related E-codes
Bill E2630 with confidence
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