MyMedi-AI

K0046 — Elevating legrest, lower extension tube, replacement only, each

HCPCS Level II K-code · short descriptor: “Elev lgrst lwr exten repl 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.

K0046 Medicare fee schedule (October 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $23.59 to $26.46 depending on state and rural status.

StateNon-ruralRural
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$26.46—
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 $28.55 depending on state and rural status.

StateNon-ruralRural
AK$25.58—
AL—$25.80
AR—$25.80
AZ—$25.45
CA—$25.45
CO—$25.80
CT—$25.80
DC—$25.80
DE—$25.80
FL—$25.80
GA—$25.80
HI$25.58—
IA—$25.45
ID—$25.45
IL—$25.80
IN—$25.80
KS—$25.45
KY—$25.80
LA—$25.80
MA—$25.80
MD—$25.80
ME—$25.80
MI—$25.80
MN—$25.80
MO—$25.80
MS—$25.80
MT—$25.45
NC—$25.80
ND—$25.45
NE—$25.45
NH—$25.80
NJ—$25.80
NM—$25.80
NV—$25.45
NY—$25.80
OH—$25.80
OK—$25.80
OR—$25.45
PA—$25.80
PR$28.55—
RI—$25.80
SC—$25.80
SD—$25.45
TN—$25.80
TX—$25.80
UT—$25.80
VA—$25.80
VI$25.80—
VT—$25.80
WA—$25.80
WI—$25.80
WV—$25.80
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

StateNon-ruralRural
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 $2.65 depending on state and rural status.

StateNon-ruralRural
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$2.65—
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.

StateNon-ruralRural
AK$2.56—
AL—$2.58
AR—$2.58
AZ—$2.55
CA—$2.55
CO—$2.58
CT—$2.58
DC—$2.58
DE—$2.58
FL—$2.58
GA—$2.58
HI$2.56—
IA—$2.55
ID—$2.55
IL—$2.58
IN—$2.58
KS—$2.55
KY—$2.58
LA—$2.58
MA—$2.58
MD—$2.58
ME—$2.58
MI—$2.58
MN—$2.58
MO—$2.58
MS—$2.58
MT—$2.55
NC—$2.58
ND—$2.55
NE—$2.55
NH—$2.58
NJ—$2.58
NM—$2.58
NV—$2.55
NY—$2.58
OH—$2.58
OK—$2.58
OR—$2.55
PA—$2.58
PR$2.85—
RI—$2.58
SC—$2.58
SD—$2.55
TN—$2.58
TX—$2.58
UT—$2.58
VA—$2.58
VI$2.58—
VT—$2.58
WA—$2.58
WI—$2.58
WV—$2.58
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

StateNon-ruralRural
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 $19.84 depending on state and rural status.

StateNon-ruralRural
AK$17.69—
AL$18.03$18.03
AR$18.03$18.03
AZ$17.69$17.69
CA$17.69$17.69
CO$18.03$18.03
CT$18.03$18.03
DC$18.03$18.03
DE$18.03$18.03
FL$18.03$18.03
GA$18.03$18.03
HI$17.69—
IA$17.69$17.69
ID$17.69$17.69
IL$18.03$18.03
IN$18.03$18.03
KS$17.69$17.69
KY$18.03$18.03
LA$18.03$18.03
MA$18.03$18.03
MD$18.03$18.03
ME$18.03$18.03
MI$18.03$18.03
MN$18.03$18.03
MO$18.03$18.03
MS$18.03$18.03
MT$17.69$17.69
NC$18.03$18.03
ND$17.69$17.69
NE$17.69$17.69
NH$18.03$18.03
NJ$18.03$18.03
NM$18.03$18.03
NV$17.69$17.69
NY$18.03$18.03
OH$18.03$18.03
OK$18.03$18.03
OR$17.69$17.69
PA$18.03$18.03
PR$19.84—
RI$18.03$18.03
SC$18.03$18.03
SD$17.69$17.69
TN$18.03$18.03
TX$18.03$18.03
UT$18.03$18.03
VA$18.03$18.03
VI$18.03—
VT$18.03$18.03
WA$18.03$18.03
WI$18.03$18.03
WV$18.03$18.03
WY$17.69$17.69

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $19.09 to $21.41 depending on state and rural status.

StateNon-ruralRural
AK$19.19—
AL—$19.38
AR—$19.38
AZ—$19.09
CA—$19.09
CO—$19.38
CT—$19.38
DC—$19.38
DE—$19.38
FL—$19.38
GA—$19.38
HI$19.19—
IA—$19.09
ID—$19.09
IL—$19.38
IN—$19.38
KS—$19.09
KY—$19.38
LA—$19.38
MA—$19.38
MD—$19.38
ME—$19.38
MI—$19.38
MN—$19.38
MO—$19.38
MS—$19.38
MT—$19.09
NC—$19.38
ND—$19.09
NE—$19.09
NH—$19.38
NJ—$19.38
NM—$19.38
NV—$19.09
NY—$19.38
OH—$19.38
OK—$19.38
OR—$19.09
PA—$19.38
PR$21.41—
RI—$19.38
SC—$19.38
SD—$19.09
TN—$19.38
TX—$19.38
UT—$19.38
VA—$19.38
VI$19.38—
VT—$19.38
WA—$19.38
WI—$19.38
WV—$19.38
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

StateNon-ruralRural
AK$17.70—
AL$18.02—
AR$18.02—
AZ$17.70—
CA$17.70—
CO$18.02—
CT$18.02—
DC$18.02—
DE$18.02—
FL$18.02—
GA$18.02—
HI$17.70—
IA$17.70—
ID$17.70—
IL$18.02—
IN$18.02—
KS$17.70—
KY$18.02—
LA$18.02—
MA$18.02—
MD$18.02—
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$18.02—
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$18.02—
VI$18.02—
VT$18.02—
WA$18.02—
WI$18.02—
WV$18.02—
WY$17.70—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps K0046 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

CO-50 medical necessityCO-151 frequency/units

Related K-codes

K0001K0002K0003K0004K0005K0006K0007K0008K0009K0010K0011K0012

Bill K0046 with confidence

Track prior-authorization requests with AI pre-fill and deadline tracking, and draft PA appeal letters — built for DME teams, PHI-free: no patient data is collected or stored.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, K0046 included, and starter credits via POST /bot-marketplace/register.