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HCPCS E2613 · Level II · DME code

E2613: Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, HCPCS Level II DME code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for E2613

Medicare payment
$354.05 to $389.71
DMEPOS non-rural state fees (NU)
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
1
MAI 2
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

E2613 is a Level II code from the E section (durable medical equipment), in use since 2005: "Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware". The October 2026 DMEPOS fee schedule (category IN, inexpensive and other routinely purchased items) sets E2613 at NU (purchased, new) $354.05 in CA, NV, OR and 1 more to $389.71 in CO, ID, MT and 2 more, rural $448.32; NU-KE (purchased, new) no state fee, rural $483.32; NU-KU (purchased, new) $482.79 in every contiguous state (floor $410.37, ceiling $482.79) (6 more modifier rows on this page). CMS caps E2613 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. 1 active LCD lists E2613: L33312 (Wheelchair Seating). OPPS status indicator Y: Non-implantable DME. HCPCS record: BETOS D1D (wheelchairs); pricing indicator 32; type of service A (used DME), P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). 5 other active codes open with "Positioning wheelchair back cushion"; related codes: E2615, E2620, E2614, E2616.

E2613 descriptor and code status

The October 2026 HCPCS Level II file describes E2613 as “Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware”. It sits in the E section (durable medical equipment), listed with the other E codes.

HCPCS file attributes of E2613
FieldValue
Short descriptorPosition back cush wd <22in
Added to HCPCS2005-01-01
Last actionN (no maintenance), effective 2005-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator32: DMEPOS inexpensive and routinely purchased DME (floors and ceilings)
BETOS categoryD1D: wheelchairs
Type of serviceA: used DME; P: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME

Medicare payment for E2613

The October 2026 DMEPOS fee schedule (category IN, inexpensive and other routinely purchased items) sets E2613 at NU (purchased, new) $354.05 in CA, NV, OR and 1 more to $389.71 in CO, ID, MT and 2 more, rural $448.32; NU-KE (purchased, new) no state fee, rural $483.32; NU-KU (purchased, new) $482.79 in every contiguous state (floor $410.37, ceiling $482.79) (6 more modifier rows on this page). The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category IN (inexpensive and other routinely purchased items). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for E2613 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
NU (purchased, new)—$354.05 (CA, NV, OR…) to $389.71 (CO, ID, MT…)$448.32 (49 states)AK $448.32, HI $448.32, PR $496.59, VI $448.32
NU (purchased, new), KE (competitive bid round 1, non-bid base equipment)——$483.32 (49 states)AK $483.32, HI $483.32, PR $538.59, VI $483.32
NU (purchased, new), KU (competitive bidding program 3 item)$410.37 / $482.79$482.79 (49 states)—AK $482.79, HI $482.79, PR $579.33, VI $482.79
RR (rental)—$35.41 (CA, NV, OR…) to $38.97 (CO, ID, MT…)$44.84 (49 states)AK $44.84, HI $44.84, PR $49.66, VI $44.84
RR (rental), KE (competitive bid round 1, non-bid base equipment)——$48.34 (49 states)AK $48.34, HI $48.34, PR $53.86, VI $48.34
RR (rental), KU (competitive bidding program 3 item)$41.05 / $48.29$48.29 (49 states)—AK $48.29, HI $48.29, PR $57.93, VI $48.29
UE (purchased, used)—$265.54 (CA, NV, OR…) to $292.28 (CO, ID, MT…)$336.24 (49 states)AK $336.24, HI $336.24, PR $372.45, VI $336.24
UE (purchased, used), KE (competitive bid round 1, non-bid base equipment)——$362.49 (49 states)AK $362.49, HI $362.49, PR $403.95, VI $362.49
UE (purchased, used), KU (competitive bidding program 3 item)$307.77 / $362.08$362.08 (49 states)—AK $362.08, HI $362.08, PR $434.50, VI $362.08

Hospital outpatient (OPPS Addendum B)

Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.

Medically Unlikely Edits for E2613

CMS caps E2613 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. The DME supplier MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.

MUE values for E2613 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier12 Date of Service Edit: PolicyCode Descriptor / CPT Instruction

The MUE lookup for E2613 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists E2613 in v323r0.

E2613 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check E2613 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for E2613

1 active Local Coverage Determination and 0 billing and coding articles list E2613. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on E2613

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists E2613

CARC 151 · N362

units of E2613 exceed the DME supplier MUE of 1 per date of service

CARC 4

the NU, KE, KU payment modifier is missing or does not match the item

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for E2613 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for E2613 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS E2613

What does HCPCS code E2613 describe?

"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware" (short descriptor "Position back cush wd <22in"), in the E section (durable medical equipment). Added 2005-01-01.

Is E2613 a CPT code?

It is not. E2613 belongs to the E section (durable medical equipment) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for E2613?

The October 2026 DMEPOS fee schedule (category IN, inexpensive and other routinely purchased items) sets E2613 at NU (purchased, new) $354.05 in CA, NV, OR and 1 more to $389.71 in CO, ID, MT and 2 more, rural $448.32; NU-KE (purchased, new) no state fee, rural $483.32; NU-KU (purchased, new) $482.79 in every contiguous state (floor $410.37, ceiling $482.79) (6 more modifier rows on this page).

How many units of E2613 can be billed per day?

CMS caps E2613 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 1 (MAI 2, Code Descriptor / CPT Instruction) units per day in the 2026 Q4 MUE tables. For the DME supplier MUE (MAI 2), units above 1 deny for the whole day as a policy limit; denials arrive as CARC 151.

Does Medicare cover E2613?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD lists E2613: L33312 (Wheelchair Seating).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.