K0017 — Detachable, adjustable height armrest, base, replacement only, each
HCPCS Level II K-code · short descriptor: “Detach adjust armrest base”
- Code system
- HCPCS Level II
- Family
- K — DME MAC temporary codes
- 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.
K0017 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $59.00 to $67.15 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $60.36 | — |
| AL | $59.00 | $60.88 |
| AR | $59.00 | $60.88 |
| AZ | $59.00 | $60.36 |
| CA | $59.00 | $60.36 |
| CO | $59.00 | $60.88 |
| CT | $59.00 | $60.88 |
| DC | $59.00 | $60.88 |
| DE | $59.00 | $60.88 |
| FL | $59.00 | $60.88 |
| GA | $59.00 | $60.88 |
| HI | $60.36 | — |
| IA | $59.00 | $60.36 |
| ID | $59.00 | $60.36 |
| IL | $59.00 | $60.88 |
| IN | $59.00 | $60.88 |
| KS | $59.00 | $60.36 |
| KY | $59.00 | $60.88 |
| LA | $59.00 | $60.88 |
| MA | $59.00 | $60.88 |
| MD | $59.00 | $60.88 |
| ME | $59.00 | $60.88 |
| MI | $59.00 | $60.88 |
| MN | $59.00 | $60.88 |
| MO | $59.00 | $60.88 |
| MS | $59.00 | $60.88 |
| MT | $59.00 | $60.36 |
| NC | $59.00 | $60.88 |
| ND | $59.00 | $60.36 |
| NE | $59.00 | $60.36 |
| NH | $59.00 | $60.88 |
| NJ | $59.00 | $60.88 |
| NM | $59.00 | $60.88 |
| NV | $59.00 | $60.36 |
| NY | $59.00 | $60.88 |
| OH | $59.00 | $60.88 |
| OK | $59.00 | $60.88 |
| OR | $59.00 | $60.36 |
| PA | $59.00 | $60.88 |
| PR | $67.15 | — |
| RI | $59.00 | $60.88 |
| SC | $59.00 | $60.88 |
| SD | $59.00 | $60.36 |
| TN | $59.00 | $60.88 |
| TX | $59.00 | $60.88 |
| UT | $59.00 | $60.88 |
| VA | $59.00 | $60.88 |
| VI | $60.88 | — |
| VT | $59.00 | $60.88 |
| WA | $59.00 | $60.88 |
| WI | $59.00 | $60.88 |
| WV | $59.00 | $60.88 |
| WY | $59.00 | $60.36 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $64.83 to $72.61 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $64.83 | — |
| AL | — | $65.44 |
| AR | — | $65.44 |
| AZ | — | $64.83 |
| CA | — | $64.83 |
| CO | — | $65.44 |
| CT | — | $65.44 |
| DC | — | $65.44 |
| DE | — | $65.44 |
| FL | — | $65.44 |
| GA | — | $65.44 |
| HI | $64.83 | — |
| IA | — | $64.83 |
| ID | — | $64.83 |
| IL | — | $65.44 |
| IN | — | $65.44 |
| KS | — | $64.83 |
| KY | — | $65.44 |
| LA | — | $65.44 |
| MA | — | $65.44 |
| MD | — | $65.44 |
| ME | — | $65.44 |
| MI | — | $65.44 |
| MN | — | $65.44 |
| MO | — | $65.44 |
| MS | — | $65.44 |
| MT | — | $64.83 |
| NC | — | $65.44 |
| ND | — | $64.83 |
| NE | — | $64.83 |
| NH | — | $65.44 |
| NJ | — | $65.44 |
| NM | — | $65.44 |
| NV | — | $64.83 |
| NY | — | $65.44 |
| OH | — | $65.44 |
| OK | — | $65.44 |
| OR | — | $64.83 |
| PA | — | $65.44 |
| PR | $72.61 | — |
| RI | — | $65.44 |
| SC | — | $65.44 |
| SD | — | $64.83 |
| TN | — | $65.44 |
| TX | — | $65.44 |
| UT | — | $65.44 |
| VA | — | $65.44 |
| VI | $65.44 | — |
| VT | — | $65.44 |
| WA | — | $65.44 |
| WI | — | $65.44 |
| WV | — | $65.44 |
| WY | — | $64.83 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $61.73 to $75.33 depending on state and rural status.
Former-CBA payment limits: ceiling $62.76 · floor $53.35
| State | Non-rural | Rural |
|---|---|---|
| AK | $61.73 | — |
| AL | $62.76 | — |
| AR | $62.76 | — |
| AZ | $61.73 | — |
| CA | $61.73 | — |
| CO | $62.76 | — |
| CT | $62.76 | — |
| DC | $62.76 | — |
| DE | $62.76 | — |
| FL | $62.76 | — |
| GA | $62.76 | — |
| HI | $61.73 | — |
| IA | $61.73 | — |
| ID | $61.73 | — |
| IL | $62.76 | — |
| IN | $62.76 | — |
| KS | $61.73 | — |
| KY | $62.76 | — |
| LA | $62.76 | — |
| MA | $62.76 | — |
| MD | $62.76 | — |
| ME | $62.76 | — |
| MI | $62.76 | — |
| MN | $62.76 | — |
| MO | $62.76 | — |
| MS | $62.76 | — |
| MT | $61.73 | — |
| NC | $62.76 | — |
| ND | $61.73 | — |
| NE | $61.73 | — |
| NH | $62.76 | — |
| NJ | $62.76 | — |
| NM | $62.76 | — |
| NV | $61.73 | — |
| NY | $62.76 | — |
| OH | $62.76 | — |
| OK | $62.76 | — |
| OR | $61.73 | — |
| PA | $62.76 | — |
| PR | $75.33 | — |
| RI | $62.76 | — |
| SC | $62.76 | — |
| SD | $61.73 | — |
| TN | $62.76 | — |
| TX | $62.76 | — |
| UT | $62.76 | — |
| VA | $62.76 | — |
| VI | $62.76 | — |
| VT | $62.76 | — |
| WA | $62.76 | — |
| WI | $62.76 | — |
| WV | $62.76 | — |
| WY | $61.73 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $5.90 to $6.72 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.04 | — |
| AL | $5.90 | $6.09 |
| AR | $5.90 | $6.09 |
| AZ | $5.90 | $6.04 |
| CA | $5.90 | $6.04 |
| CO | $5.90 | $6.09 |
| CT | $5.90 | $6.09 |
| DC | $5.90 | $6.09 |
| DE | $5.90 | $6.09 |
| FL | $5.90 | $6.09 |
| GA | $5.90 | $6.09 |
| HI | $6.04 | — |
| IA | $5.90 | $6.04 |
| ID | $5.90 | $6.04 |
| IL | $5.90 | $6.09 |
| IN | $5.90 | $6.09 |
| KS | $5.90 | $6.04 |
| KY | $5.90 | $6.09 |
| LA | $5.90 | $6.09 |
| MA | $5.90 | $6.09 |
| MD | $5.90 | $6.09 |
| ME | $5.90 | $6.09 |
| MI | $5.90 | $6.09 |
| MN | $5.90 | $6.09 |
| MO | $5.90 | $6.09 |
| MS | $5.90 | $6.09 |
| MT | $5.90 | $6.04 |
| NC | $5.90 | $6.09 |
| ND | $5.90 | $6.04 |
| NE | $5.90 | $6.04 |
| NH | $5.90 | $6.09 |
| NJ | $5.90 | $6.09 |
| NM | $5.90 | $6.09 |
| NV | $5.90 | $6.04 |
| NY | $5.90 | $6.09 |
| OH | $5.90 | $6.09 |
| OK | $5.90 | $6.09 |
| OR | $5.90 | $6.04 |
| PA | $5.90 | $6.09 |
| PR | $6.72 | — |
| RI | $5.90 | $6.09 |
| SC | $5.90 | $6.09 |
| SD | $5.90 | $6.04 |
| TN | $5.90 | $6.09 |
| TX | $5.90 | $6.09 |
| UT | $5.90 | $6.09 |
| VA | $5.90 | $6.09 |
| VI | $6.09 | — |
| VT | $5.90 | $6.09 |
| WA | $5.90 | $6.09 |
| WI | $5.90 | $6.09 |
| WV | $5.90 | $6.09 |
| WY | $5.90 | $6.04 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.49 to $7.27 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.49 | — |
| AL | — | $6.54 |
| AR | — | $6.54 |
| AZ | — | $6.49 |
| CA | — | $6.49 |
| CO | — | $6.54 |
| CT | — | $6.54 |
| DC | — | $6.54 |
| DE | — | $6.54 |
| FL | — | $6.54 |
| GA | — | $6.54 |
| HI | $6.49 | — |
| IA | — | $6.49 |
| ID | — | $6.49 |
| IL | — | $6.54 |
| IN | — | $6.54 |
| KS | — | $6.49 |
| KY | — | $6.54 |
| LA | — | $6.54 |
| MA | — | $6.54 |
| MD | — | $6.54 |
| ME | — | $6.54 |
| MI | — | $6.54 |
| MN | — | $6.54 |
| MO | — | $6.54 |
| MS | — | $6.54 |
| MT | — | $6.49 |
| NC | — | $6.54 |
| ND | — | $6.49 |
| NE | — | $6.49 |
| NH | — | $6.54 |
| NJ | — | $6.54 |
| NM | — | $6.54 |
| NV | — | $6.49 |
| NY | — | $6.54 |
| OH | — | $6.54 |
| OK | — | $6.54 |
| OR | — | $6.49 |
| PA | — | $6.54 |
| PR | $7.27 | — |
| RI | — | $6.54 |
| SC | — | $6.54 |
| SD | — | $6.49 |
| TN | — | $6.54 |
| TX | — | $6.54 |
| UT | — | $6.54 |
| VA | — | $6.54 |
| VI | $6.54 | — |
| VT | — | $6.54 |
| WA | — | $6.54 |
| WI | — | $6.54 |
| WV | — | $6.54 |
| WY | — | $6.49 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $6.17 to $7.53 depending on state and rural status.
Former-CBA payment limits: ceiling $6.26 · floor $5.32
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.17 | — |
| AL | $6.26 | — |
| AR | $6.26 | — |
| AZ | $6.17 | — |
| CA | $6.17 | — |
| CO | $6.26 | — |
| CT | $6.26 | — |
| DC | $6.26 | — |
| DE | $6.26 | — |
| FL | $6.26 | — |
| GA | $6.26 | — |
| HI | $6.17 | — |
| IA | $6.17 | — |
| ID | $6.17 | — |
| IL | $6.26 | — |
| IN | $6.26 | — |
| KS | $6.17 | — |
| KY | $6.26 | — |
| LA | $6.26 | — |
| MA | $6.26 | — |
| MD | $6.26 | — |
| ME | $6.26 | — |
| MI | $6.26 | — |
| MN | $6.26 | — |
| MO | $6.26 | — |
| MS | $6.26 | — |
| MT | $6.17 | — |
| NC | $6.26 | — |
| ND | $6.17 | — |
| NE | $6.17 | — |
| NH | $6.26 | — |
| NJ | $6.26 | — |
| NM | $6.26 | — |
| NV | $6.17 | — |
| NY | $6.26 | — |
| OH | $6.26 | — |
| OK | $6.26 | — |
| OR | $6.17 | — |
| PA | $6.26 | — |
| PR | $7.53 | — |
| RI | $6.26 | — |
| SC | $6.26 | — |
| SD | $6.17 | — |
| TN | $6.26 | — |
| TX | $6.26 | — |
| UT | $6.26 | — |
| VA | $6.26 | — |
| VI | $6.26 | — |
| VT | $6.26 | — |
| WA | $6.26 | — |
| WI | $6.26 | — |
| WV | $6.26 | — |
| WY | $6.17 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $44.25 to $50.37 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $45.27 | — |
| AL | $44.25 | $45.67 |
| AR | $44.25 | $45.67 |
| AZ | $44.25 | $45.27 |
| CA | $44.25 | $45.27 |
| CO | $44.25 | $45.67 |
| CT | $44.25 | $45.67 |
| DC | $44.25 | $45.67 |
| DE | $44.25 | $45.67 |
| FL | $44.25 | $45.67 |
| GA | $44.25 | $45.67 |
| HI | $45.27 | — |
| IA | $44.25 | $45.27 |
| ID | $44.25 | $45.27 |
| IL | $44.25 | $45.67 |
| IN | $44.25 | $45.67 |
| KS | $44.25 | $45.27 |
| KY | $44.25 | $45.67 |
| LA | $44.25 | $45.67 |
| MA | $44.25 | $45.67 |
| MD | $44.25 | $45.67 |
| ME | $44.25 | $45.67 |
| MI | $44.25 | $45.67 |
| MN | $44.25 | $45.67 |
| MO | $44.25 | $45.67 |
| MS | $44.25 | $45.67 |
| MT | $44.25 | $45.27 |
| NC | $44.25 | $45.67 |
| ND | $44.25 | $45.27 |
| NE | $44.25 | $45.27 |
| NH | $44.25 | $45.67 |
| NJ | $44.25 | $45.67 |
| NM | $44.25 | $45.67 |
| NV | $44.25 | $45.27 |
| NY | $44.25 | $45.67 |
| OH | $44.25 | $45.67 |
| OK | $44.25 | $45.67 |
| OR | $44.25 | $45.27 |
| PA | $44.25 | $45.67 |
| PR | $50.37 | — |
| RI | $44.25 | $45.67 |
| SC | $44.25 | $45.67 |
| SD | $44.25 | $45.27 |
| TN | $44.25 | $45.67 |
| TX | $44.25 | $45.67 |
| UT | $44.25 | $45.67 |
| VA | $44.25 | $45.67 |
| VI | $45.67 | — |
| VT | $44.25 | $45.67 |
| WA | $44.25 | $45.67 |
| WI | $44.25 | $45.67 |
| WV | $44.25 | $45.67 |
| WY | $44.25 | $45.27 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $48.62 to $54.46 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $48.62 | — |
| AL | — | $49.08 |
| AR | — | $49.08 |
| AZ | — | $48.62 |
| CA | — | $48.62 |
| CO | — | $49.08 |
| CT | — | $49.08 |
| DC | — | $49.08 |
| DE | — | $49.08 |
| FL | — | $49.08 |
| GA | — | $49.08 |
| HI | $48.62 | — |
| IA | — | $48.62 |
| ID | — | $48.62 |
| IL | — | $49.08 |
| IN | — | $49.08 |
| KS | — | $48.62 |
| KY | — | $49.08 |
| LA | — | $49.08 |
| MA | — | $49.08 |
| MD | — | $49.08 |
| ME | — | $49.08 |
| MI | — | $49.08 |
| MN | — | $49.08 |
| MO | — | $49.08 |
| MS | — | $49.08 |
| MT | — | $48.62 |
| NC | — | $49.08 |
| ND | — | $48.62 |
| NE | — | $48.62 |
| NH | — | $49.08 |
| NJ | — | $49.08 |
| NM | — | $49.08 |
| NV | — | $48.62 |
| NY | — | $49.08 |
| OH | — | $49.08 |
| OK | — | $49.08 |
| OR | — | $48.62 |
| PA | — | $49.08 |
| PR | $54.46 | — |
| RI | — | $49.08 |
| SC | — | $49.08 |
| SD | — | $48.62 |
| TN | — | $49.08 |
| TX | — | $49.08 |
| UT | — | $49.08 |
| VA | — | $49.08 |
| VI | $49.08 | — |
| VT | — | $49.08 |
| WA | — | $49.08 |
| WI | — | $49.08 |
| WV | — | $49.08 |
| WY | — | $48.62 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $46.30 to $56.49 depending on state and rural status.
Former-CBA payment limits: ceiling $47.08 · floor $40.02
| State | Non-rural | Rural |
|---|---|---|
| AK | $46.30 | — |
| AL | $47.08 | — |
| AR | $47.08 | — |
| AZ | $46.30 | — |
| CA | $46.30 | — |
| CO | $47.08 | — |
| CT | $47.08 | — |
| DC | $47.08 | — |
| DE | $47.08 | — |
| FL | $47.08 | — |
| GA | $47.08 | — |
| HI | $46.30 | — |
| IA | $46.30 | — |
| ID | $46.30 | — |
| IL | $47.08 | — |
| IN | $47.08 | — |
| KS | $46.30 | — |
| KY | $47.08 | — |
| LA | $47.08 | — |
| MA | $47.08 | — |
| MD | $47.08 | — |
| ME | $47.08 | — |
| MI | $47.08 | — |
| MN | $47.08 | — |
| MO | $47.08 | — |
| MS | $47.08 | — |
| MT | $46.30 | — |
| NC | $47.08 | — |
| ND | $46.30 | — |
| NE | $46.30 | — |
| NH | $47.08 | — |
| NJ | $47.08 | — |
| NM | $47.08 | — |
| NV | $46.30 | — |
| NY | $47.08 | — |
| OH | $47.08 | — |
| OK | $47.08 | — |
| OR | $46.30 | — |
| PA | $47.08 | — |
| PR | $56.49 | — |
| RI | $47.08 | — |
| SC | $47.08 | — |
| SD | $46.30 | — |
| TN | $47.08 | — |
| TX | $47.08 | — |
| UT | $47.08 | — |
| VA | $47.08 | — |
| VI | $47.08 | — |
| VT | $47.08 | — |
| WA | $47.08 | — |
| WI | $47.08 | — |
| WV | $47.08 | — |
| WY | $46.30 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps K0017 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 K-codes
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