K0043 — Footrest, lower extension tube, replacement only, each
HCPCS Level II K-code · short descriptor: “Ftrst lowr exten tube rep ea”
- 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.
K0043 Medicare fee schedule (October 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $23.59 to $26.38 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $23.59 | — |
| AL | $23.97 | $23.97 |
| AR | $23.97 | $23.97 |
| AZ | $23.59 | $23.59 |
| CA | $23.59 | $23.59 |
| CO | $23.97 | $23.97 |
| CT | $23.97 | $23.97 |
| DC | $23.97 | $23.97 |
| DE | $23.97 | $23.97 |
| FL | $23.97 | $23.97 |
| GA | $23.97 | $23.97 |
| HI | $23.59 | — |
| IA | $23.59 | $23.59 |
| ID | $23.59 | $23.59 |
| IL | $23.97 | $23.97 |
| IN | $23.97 | $23.97 |
| KS | $23.59 | $23.59 |
| KY | $23.97 | $23.97 |
| LA | $23.97 | $23.97 |
| MA | $23.97 | $23.97 |
| MD | $23.97 | $23.97 |
| ME | $23.97 | $23.97 |
| MI | $23.97 | $23.97 |
| MN | $23.97 | $23.97 |
| MO | $23.97 | $23.97 |
| MS | $23.97 | $23.97 |
| MT | $23.59 | $23.59 |
| NC | $23.97 | $23.97 |
| ND | $23.59 | $23.59 |
| NE | $23.59 | $23.59 |
| NH | $23.97 | $23.97 |
| NJ | $23.97 | $23.97 |
| NM | $23.97 | $23.97 |
| NV | $23.59 | $23.59 |
| NY | $23.97 | $23.97 |
| OH | $23.97 | $23.97 |
| OK | $23.97 | $23.97 |
| OR | $23.59 | $23.59 |
| PA | $23.97 | $23.97 |
| PR | $26.38 | — |
| RI | $23.97 | $23.97 |
| SC | $23.97 | $23.97 |
| SD | $23.59 | $23.59 |
| TN | $23.97 | $23.97 |
| TX | $23.97 | $23.97 |
| UT | $23.97 | $23.97 |
| VA | $23.97 | $23.97 |
| VI | $23.97 | — |
| VT | $23.97 | $23.97 |
| WA | $23.97 | $23.97 |
| WI | $23.97 | $23.97 |
| WV | $23.97 | $23.97 |
| WY | $23.59 | $23.59 |
NU + KE — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $25.45 to $28.47 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $25.50 | — |
| AL | — | $25.72 |
| AR | — | $25.72 |
| AZ | — | $25.45 |
| CA | — | $25.45 |
| CO | — | $25.72 |
| CT | — | $25.72 |
| DC | — | $25.72 |
| DE | — | $25.72 |
| FL | — | $25.72 |
| GA | — | $25.72 |
| HI | $25.50 | — |
| IA | — | $25.45 |
| ID | — | $25.45 |
| IL | — | $25.72 |
| IN | — | $25.72 |
| KS | — | $25.45 |
| KY | — | $25.72 |
| LA | — | $25.72 |
| MA | — | $25.72 |
| MD | — | $25.72 |
| ME | — | $25.72 |
| MI | — | $25.72 |
| MN | — | $25.72 |
| MO | — | $25.72 |
| MS | — | $25.72 |
| MT | — | $25.45 |
| NC | — | $25.72 |
| ND | — | $25.45 |
| NE | — | $25.45 |
| NH | — | $25.72 |
| NJ | — | $25.72 |
| NM | — | $25.72 |
| NV | — | $25.45 |
| NY | — | $25.72 |
| OH | — | $25.72 |
| OK | — | $25.72 |
| OR | — | $25.45 |
| PA | — | $25.72 |
| PR | $28.47 | — |
| RI | — | $25.72 |
| SC | — | $25.72 |
| SD | — | $25.45 |
| TN | — | $25.72 |
| TX | — | $25.72 |
| UT | — | $25.72 |
| VA | — | $25.72 |
| VI | $25.72 | — |
| VT | — | $25.72 |
| WA | — | $25.72 |
| WI | — | $25.72 |
| WV | — | $25.72 |
| WY | — | $25.45 |
NU + KU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $23.58 to $28.78 depending on state and rural status.
Former-CBA payment limits: ceiling $23.98 · floor $20.38
| State | Non-rural | Rural |
|---|---|---|
| AK | $23.58 | — |
| AL | $23.98 | — |
| AR | $23.98 | — |
| AZ | $23.58 | — |
| CA | $23.58 | — |
| CO | $23.98 | — |
| CT | $23.98 | — |
| DC | $23.98 | — |
| DE | $23.98 | — |
| FL | $23.98 | — |
| GA | $23.98 | — |
| HI | $23.58 | — |
| IA | $23.58 | — |
| ID | $23.58 | — |
| IL | $23.98 | — |
| IN | $23.98 | — |
| KS | $23.58 | — |
| KY | $23.98 | — |
| LA | $23.98 | — |
| MA | $23.98 | — |
| MD | $23.98 | — |
| ME | $23.98 | — |
| MI | $23.98 | — |
| MN | $23.98 | — |
| MO | $23.98 | — |
| MS | $23.98 | — |
| MT | $23.58 | — |
| NC | $23.98 | — |
| ND | $23.58 | — |
| NE | $23.58 | — |
| NH | $23.98 | — |
| NJ | $23.98 | — |
| NM | $23.98 | — |
| NV | $23.58 | — |
| NY | $23.98 | — |
| OH | $23.98 | — |
| OK | $23.98 | — |
| OR | $23.58 | — |
| PA | $23.98 | — |
| PR | $28.78 | — |
| RI | $23.98 | — |
| SC | $23.98 | — |
| SD | $23.58 | — |
| TN | $23.98 | — |
| TX | $23.98 | — |
| UT | $23.98 | — |
| VA | $23.98 | — |
| VI | $23.98 | — |
| VT | $23.98 | — |
| WA | $23.98 | — |
| WI | $23.98 | — |
| WV | $23.98 | — |
| WY | $23.58 | — |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $2.36 to $2.64 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $2.36 | — |
| AL | $2.39 | $2.39 |
| AR | $2.39 | $2.39 |
| AZ | $2.36 | $2.36 |
| CA | $2.36 | $2.36 |
| CO | $2.39 | $2.39 |
| CT | $2.39 | $2.39 |
| DC | $2.39 | $2.39 |
| DE | $2.39 | $2.39 |
| FL | $2.39 | $2.39 |
| GA | $2.39 | $2.39 |
| HI | $2.36 | — |
| IA | $2.36 | $2.36 |
| ID | $2.36 | $2.36 |
| IL | $2.39 | $2.39 |
| IN | $2.39 | $2.39 |
| KS | $2.36 | $2.36 |
| KY | $2.39 | $2.39 |
| LA | $2.39 | $2.39 |
| MA | $2.39 | $2.39 |
| MD | $2.39 | $2.39 |
| ME | $2.39 | $2.39 |
| MI | $2.39 | $2.39 |
| MN | $2.39 | $2.39 |
| MO | $2.39 | $2.39 |
| MS | $2.39 | $2.39 |
| MT | $2.36 | $2.36 |
| NC | $2.39 | $2.39 |
| ND | $2.36 | $2.36 |
| NE | $2.36 | $2.36 |
| NH | $2.39 | $2.39 |
| NJ | $2.39 | $2.39 |
| NM | $2.39 | $2.39 |
| NV | $2.36 | $2.36 |
| NY | $2.39 | $2.39 |
| OH | $2.39 | $2.39 |
| OK | $2.39 | $2.39 |
| OR | $2.36 | $2.36 |
| PA | $2.39 | $2.39 |
| PR | $2.64 | — |
| RI | $2.39 | $2.39 |
| SC | $2.39 | $2.39 |
| SD | $2.36 | $2.36 |
| TN | $2.39 | $2.39 |
| TX | $2.39 | $2.39 |
| UT | $2.39 | $2.39 |
| VA | $2.39 | $2.39 |
| VI | $2.39 | — |
| VT | $2.39 | $2.39 |
| WA | $2.39 | $2.39 |
| WI | $2.39 | $2.39 |
| WV | $2.39 | $2.39 |
| WY | $2.36 | $2.36 |
RR + KE — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $2.55 to $2.85 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $2.55 | — |
| AL | — | $2.57 |
| AR | — | $2.57 |
| AZ | — | $2.55 |
| CA | — | $2.55 |
| CO | — | $2.57 |
| CT | — | $2.57 |
| DC | — | $2.57 |
| DE | — | $2.57 |
| FL | — | $2.57 |
| GA | — | $2.57 |
| HI | $2.55 | — |
| IA | — | $2.55 |
| ID | — | $2.55 |
| IL | — | $2.57 |
| IN | — | $2.57 |
| KS | — | $2.55 |
| KY | — | $2.57 |
| LA | — | $2.57 |
| MA | — | $2.57 |
| MD | — | $2.57 |
| ME | — | $2.57 |
| MI | — | $2.57 |
| MN | — | $2.57 |
| MO | — | $2.57 |
| MS | — | $2.57 |
| MT | — | $2.55 |
| NC | — | $2.57 |
| ND | — | $2.55 |
| NE | — | $2.55 |
| NH | — | $2.57 |
| NJ | — | $2.57 |
| NM | — | $2.57 |
| NV | — | $2.55 |
| NY | — | $2.57 |
| OH | — | $2.57 |
| OK | — | $2.57 |
| OR | — | $2.55 |
| PA | — | $2.57 |
| PR | $2.85 | — |
| RI | — | $2.57 |
| SC | — | $2.57 |
| SD | — | $2.55 |
| TN | — | $2.57 |
| TX | — | $2.57 |
| UT | — | $2.57 |
| VA | — | $2.57 |
| VI | $2.57 | — |
| VT | — | $2.57 |
| WA | — | $2.57 |
| WI | — | $2.57 |
| WV | — | $2.57 |
| WY | — | $2.55 |
RR + KU — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $2.36 to $2.87 depending on state and rural status.
Former-CBA payment limits: ceiling $2.38 · floor $2.02
| State | Non-rural | Rural |
|---|---|---|
| AK | $2.36 | — |
| AL | $2.38 | — |
| AR | $2.38 | — |
| AZ | $2.36 | — |
| CA | $2.36 | — |
| CO | $2.38 | — |
| CT | $2.38 | — |
| DC | $2.38 | — |
| DE | $2.38 | — |
| FL | $2.38 | — |
| GA | $2.38 | — |
| HI | $2.36 | — |
| IA | $2.36 | — |
| ID | $2.36 | — |
| IL | $2.38 | — |
| IN | $2.38 | — |
| KS | $2.36 | — |
| KY | $2.38 | — |
| LA | $2.38 | — |
| MA | $2.38 | — |
| MD | $2.38 | — |
| ME | $2.38 | — |
| MI | $2.38 | — |
| MN | $2.38 | — |
| MO | $2.38 | — |
| MS | $2.38 | — |
| MT | $2.36 | — |
| NC | $2.38 | — |
| ND | $2.36 | — |
| NE | $2.36 | — |
| NH | $2.38 | — |
| NJ | $2.38 | — |
| NM | $2.38 | — |
| NV | $2.36 | — |
| NY | $2.38 | — |
| OH | $2.38 | — |
| OK | $2.38 | — |
| OR | $2.36 | — |
| PA | $2.38 | — |
| PR | $2.87 | — |
| RI | $2.38 | — |
| SC | $2.38 | — |
| SD | $2.36 | — |
| TN | $2.38 | — |
| TX | $2.38 | — |
| UT | $2.38 | — |
| VA | $2.38 | — |
| VI | $2.38 | — |
| VT | $2.38 | — |
| WA | $2.38 | — |
| WI | $2.38 | — |
| WV | $2.38 | — |
| WY | $2.36 | — |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $17.69 to $19.78 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $17.69 | — |
| AL | $17.99 | $18.01 |
| AR | $17.99 | $18.01 |
| AZ | $17.69 | $17.69 |
| CA | $17.69 | $17.69 |
| CO | $17.99 | $18.01 |
| CT | $17.99 | $18.01 |
| DC | $17.99 | $18.00 |
| DE | $17.99 | $18.01 |
| FL | $17.99 | $18.01 |
| GA | $17.99 | $18.01 |
| HI | $17.69 | — |
| IA | $17.69 | $17.69 |
| ID | $17.69 | $17.69 |
| IL | $17.99 | $18.00 |
| IN | $17.99 | $18.01 |
| KS | $17.69 | $17.69 |
| KY | $17.99 | $18.01 |
| LA | $17.99 | $18.01 |
| MA | $17.99 | $18.01 |
| MD | $17.99 | $18.00 |
| ME | $17.99 | $18.01 |
| MI | $17.99 | $18.01 |
| MN | $17.99 | $18.01 |
| MO | $17.99 | $18.01 |
| MS | $17.99 | $18.01 |
| MT | $17.69 | $17.69 |
| NC | $17.99 | $18.01 |
| ND | $17.69 | $17.69 |
| NE | $17.69 | $17.69 |
| NH | $17.99 | $18.01 |
| NJ | $17.99 | $18.01 |
| NM | $17.99 | $18.01 |
| NV | $17.69 | $17.69 |
| NY | $17.99 | $18.01 |
| OH | $17.99 | $18.00 |
| OK | $17.99 | $18.01 |
| OR | $17.69 | $17.69 |
| PA | $17.99 | $18.01 |
| PR | $19.78 | — |
| RI | $17.99 | $18.01 |
| SC | $17.99 | $18.01 |
| SD | $17.69 | $17.69 |
| TN | $17.99 | $18.01 |
| TX | $17.99 | $18.01 |
| UT | $17.99 | $18.01 |
| VA | $17.99 | $18.00 |
| VI | $18.01 | — |
| VT | $17.99 | $18.01 |
| WA | $17.99 | $18.01 |
| WI | $17.99 | $18.01 |
| WV | $17.99 | $18.00 |
| WY | $17.69 | $17.69 |
UE + KE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $19.09 to $21.35 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $19.13 | — |
| AL | — | $19.32 |
| AR | — | $19.32 |
| AZ | — | $19.09 |
| CA | — | $19.09 |
| CO | — | $19.32 |
| CT | — | $19.32 |
| DC | — | $19.30 |
| DE | — | $19.32 |
| FL | — | $19.32 |
| GA | — | $19.32 |
| HI | $19.13 | — |
| IA | — | $19.09 |
| ID | — | $19.09 |
| IL | — | $19.30 |
| IN | — | $19.32 |
| KS | — | $19.09 |
| KY | — | $19.32 |
| LA | — | $19.32 |
| MA | — | $19.32 |
| MD | — | $19.30 |
| ME | — | $19.32 |
| MI | — | $19.32 |
| MN | — | $19.32 |
| MO | — | $19.32 |
| MS | — | $19.32 |
| MT | — | $19.09 |
| NC | — | $19.32 |
| ND | — | $19.09 |
| NE | — | $19.09 |
| NH | — | $19.32 |
| NJ | — | $19.32 |
| NM | — | $19.32 |
| NV | — | $19.09 |
| NY | — | $19.32 |
| OH | — | $19.30 |
| OK | — | $19.32 |
| OR | — | $19.09 |
| PA | — | $19.32 |
| PR | $21.35 | — |
| RI | — | $19.32 |
| SC | — | $19.32 |
| SD | — | $19.09 |
| TN | — | $19.32 |
| TX | — | $19.32 |
| UT | — | $19.32 |
| VA | — | $19.30 |
| VI | $19.32 | — |
| VT | — | $19.32 |
| WA | — | $19.32 |
| WI | — | $19.32 |
| WV | — | $19.30 |
| WY | — | $19.09 |
UE + KU — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $17.70 to $21.58 depending on state and rural status.
Former-CBA payment limits: ceiling $18.02 · floor $15.32
| State | Non-rural | Rural |
|---|---|---|
| AK | $17.70 | — |
| AL | $18.02 | — |
| AR | $18.02 | — |
| AZ | $17.70 | — |
| CA | $17.70 | — |
| CO | $18.02 | — |
| CT | $18.02 | — |
| DC | $17.99 | — |
| DE | $18.02 | — |
| FL | $18.02 | — |
| GA | $18.02 | — |
| HI | $17.70 | — |
| IA | $17.70 | — |
| ID | $17.70 | — |
| IL | $17.99 | — |
| IN | $18.02 | — |
| KS | $17.70 | — |
| KY | $18.02 | — |
| LA | $18.02 | — |
| MA | $18.02 | — |
| MD | $17.99 | — |
| ME | $18.02 | — |
| MI | $18.02 | — |
| MN | $18.02 | — |
| MO | $18.02 | — |
| MS | $18.02 | — |
| MT | $17.70 | — |
| NC | $18.02 | — |
| ND | $17.70 | — |
| NE | $17.70 | — |
| NH | $18.02 | — |
| NJ | $18.02 | — |
| NM | $18.02 | — |
| NV | $17.70 | — |
| NY | $18.02 | — |
| OH | $17.99 | — |
| OK | $18.02 | — |
| OR | $17.70 | — |
| PA | $18.02 | — |
| PR | $21.58 | — |
| RI | $18.02 | — |
| SC | $18.02 | — |
| SD | $17.70 | — |
| TN | $18.02 | — |
| TX | $18.02 | — |
| UT | $18.02 | — |
| VA | $17.99 | — |
| VI | $18.02 | — |
| VT | $18.02 | — |
| WA | $18.02 | — |
| WI | $18.02 | — |
| WV | $17.99 | — |
| WY | $17.70 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps K0043 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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