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K0069 — Rear wheel assembly, complete, with solid tire, spokes or molded, replacement only, each

HCPCS Level II K-code · short descriptor: “Rr whl compl sol tire 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
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.

K0069 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $110.80 to $155.21 depending on state and rural status.

StateNon-ruralRural
AK$139.78
AL$115.72$134.69
AR$115.72$134.69
AZ$113.20$133.47
CA$110.80$133.47
CO$117.43$134.69
CT$116.52$134.69
DC$114.08$134.69
DE$114.08$134.69
FL$115.72$134.69
GA$115.72$134.69
HI$139.78
IA$113.74$133.47
ID$117.43$133.47
IL$120.77$134.69
IN$120.77$134.69
KS$113.74$133.47
KY$115.72$134.69
LA$115.72$134.69
MA$116.52$134.69
MD$114.08$134.69
ME$116.52$134.69
MI$120.77$134.69
MN$113.74$134.69
MO$113.74$134.69
MS$115.72$134.69
MT$117.43$133.47
NC$115.72$134.69
ND$113.74$133.47
NE$113.74$133.47
NH$116.52$134.69
NJ$114.08$134.69
NM$113.20$134.69
NV$110.80$133.47
NY$114.08$134.69
OH$120.77$134.69
OK$113.20$134.69
OR$110.80$133.47
PA$114.08$134.69
PR$155.21
RI$116.52$134.69
SC$115.72$134.69
SD$113.74$133.47
TN$115.72$134.69
TX$113.20$134.69
UT$117.43$134.69
VA$115.72$134.69
VI$141.00
VT$116.52$134.69
WA$110.80$133.47
WI$120.77$134.69
WV$115.72$134.69
WY$117.43$133.47

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $139.97 to $170.84 depending on state and rural status.

Former-CBA payment limits: ceiling $142.42 · floor $121.06

StateNon-ruralRural
AK$139.97
AL$142.42
AR$142.42
AZ$139.97
CA$139.97
CO$142.42
CT$142.42
DC$142.42
DE$142.42
FL$142.42
GA$142.42
HI$139.97
IA$139.97
ID$139.97
IL$142.42
IN$142.42
KS$139.97
KY$142.42
LA$142.42
MA$142.42
MD$142.42
ME$142.42
MI$142.42
MN$142.42
MO$142.42
MS$142.42
MT$139.97
NC$142.42
ND$139.97
NE$139.97
NH$142.42
NJ$142.42
NM$142.42
NV$139.97
NY$142.42
OH$142.42
OK$142.42
OR$139.97
PA$142.42
PR$170.84
RI$142.42
SC$142.42
SD$139.97
TN$142.42
TX$142.42
UT$142.42
VA$142.42
VI$142.42
VT$142.42
WA$139.97
WI$142.42
WV$142.42
WY$139.97

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $11.08 to $15.52 depending on state and rural status.

StateNon-ruralRural
AK$13.99
AL$11.57$13.76
AR$11.57$13.76
AZ$11.32$13.36
CA$11.08$13.36
CO$11.74$13.76
CT$11.65$13.76
DC$11.41$13.76
DE$11.41$13.47
FL$11.57$13.47
GA$11.57$13.76
HI$13.99
IA$11.38$13.36
ID$11.74$13.36
IL$12.08$13.76
IN$12.08$13.76
KS$11.38$13.36
KY$11.57$13.76
LA$11.57$13.76
MA$11.65$13.76
MD$11.41$13.76
ME$11.65$13.76
MI$12.08$13.76
MN$11.38$13.76
MO$11.38$13.64
MS$11.57$13.76
MT$11.74$13.36
NC$11.57$13.67
ND$11.38$13.36
NE$11.38$13.36
NH$11.65$13.47
NJ$11.41$13.47
NM$11.32$13.76
NV$11.08$13.36
NY$11.41$13.47
OH$12.08$13.76
OK$11.32$13.76
OR$11.08$13.36
PA$11.41$13.47
PR$15.52
RI$11.65$13.47
SC$11.57$13.76
SD$11.38$13.36
TN$11.57$13.76
TX$11.32$13.47
UT$11.74$13.76
VA$11.57$13.76
VI$14.10
VT$11.65$13.76
WA$11.08$13.36
WI$12.08$13.76
WV$11.57$13.76
WY$11.74$13.36

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $14.01 to $17.07 depending on state and rural status.

Former-CBA payment limits: ceiling $14.83 · floor $12.61

StateNon-ruralRural
AK$14.01
AL$14.83
AR$14.83
AZ$14.01
CA$14.01
CO$14.83
CT$14.83
DC$14.83
DE$14.24
FL$14.24
GA$14.83
HI$14.01
IA$14.01
ID$14.01
IL$14.83
IN$14.83
KS$14.01
KY$14.83
LA$14.83
MA$14.83
MD$14.83
ME$14.83
MI$14.83
MN$14.83
MO$14.59
MS$14.83
MT$14.01
NC$14.66
ND$14.01
NE$14.01
NH$14.24
NJ$14.24
NM$14.83
NV$14.01
NY$14.24
OH$14.83
OK$14.83
OR$14.01
PA$14.24
PR$17.07
RI$14.24
SC$14.83
SD$14.01
TN$14.83
TX$14.24
UT$14.83
VA$14.83
VI$14.24
VT$14.83
WA$14.01
WI$14.83
WV$14.83
WY$14.01

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $83.10 to $116.43 depending on state and rural status.

StateNon-ruralRural
AK$104.84
AL$86.79$101.01
AR$86.79$101.01
AZ$84.90$100.11
CA$83.10$100.11
CO$88.07$101.01
CT$87.40$101.01
DC$85.56$101.01
DE$85.56$101.01
FL$86.79$101.01
GA$86.79$101.01
HI$104.84
IA$85.31$100.11
ID$88.07$100.11
IL$90.58$101.01
IN$90.58$101.01
KS$85.31$100.11
KY$86.79$101.01
LA$86.79$101.01
MA$87.40$101.01
MD$85.56$101.01
ME$87.40$101.01
MI$90.58$101.01
MN$85.31$101.01
MO$85.31$101.01
MS$86.79$101.01
MT$88.07$100.11
NC$86.79$101.01
ND$85.31$100.11
NE$85.31$100.11
NH$87.40$101.01
NJ$85.56$101.01
NM$84.90$101.01
NV$83.10$100.11
NY$85.56$101.01
OH$90.58$101.01
OK$84.90$101.01
OR$83.10$100.11
PA$85.56$101.01
PR$116.43
RI$87.40$101.01
SC$86.79$101.01
SD$85.31$100.11
TN$86.79$101.01
TX$84.90$101.01
UT$88.07$101.01
VA$86.79$101.01
VI$105.74
VT$87.40$101.01
WA$83.10$100.11
WI$90.58$101.01
WV$86.79$101.01
WY$88.07$100.11

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $104.98 to $128.17 depending on state and rural status.

Former-CBA payment limits: ceiling $106.80 · floor $90.78

StateNon-ruralRural
AK$104.98
AL$106.80
AR$106.80
AZ$104.98
CA$104.98
CO$106.80
CT$106.80
DC$106.80
DE$106.80
FL$106.80
GA$106.80
HI$104.98
IA$104.98
ID$104.98
IL$106.80
IN$106.80
KS$104.98
KY$106.80
LA$106.80
MA$106.80
MD$106.80
ME$106.80
MI$106.80
MN$106.80
MO$106.80
MS$106.80
MT$104.98
NC$106.80
ND$104.98
NE$104.98
NH$106.80
NJ$106.80
NM$106.80
NV$104.98
NY$106.80
OH$106.80
OK$106.80
OR$104.98
PA$106.80
PR$128.17
RI$106.80
SC$106.80
SD$104.98
TN$106.80
TX$106.80
UT$106.80
VA$106.80
VI$106.80
VT$106.80
WA$104.98
WI$106.80
WV$106.80
WY$104.98
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.

Common denial codes to watch

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