E2609 HCPCS code: Custom fabricated wheelchair seat cushion, any size
E2609 is the HCPCS Level II code for custom fabricated wheelchair seat cushion, any size. In 2024 Medicare paid an average of $1,466.09 per service for E2609 across 2,733 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on DME suppliers. Medicare volume rose 8% from 2022 to 2024 (2,524 to 2,733 services). In 2024, 422 suppliers billed Medicare for E2609 (purchases), serving 2,724 beneficiaries; Ohio, New York, California accounted for 32% of services.
Code details
| Field | Value |
|---|---|
| Section | E codes — Durable medical equipment |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1D — Wheelchairs |
| Added | 2005-01-01 |
| Last action effective | 2005-01-01 |
Who bills E2609 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 422 |
| Referring clinicians | 2,010 |
| Medicare beneficiaries | 2,724 |
| States with claims | 42 |
| Share of services in top 3 states (Ohio, New York, California) | 32% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 366 | 2,519 |
| 2023 | 404 | 2,633 |
| 2024 | 422 | 2,724 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for E2609, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,524 | 2,519 | $1,604.86 | $1,258.33 |
| 2023 | 2,636 | 2,633 | $1,689.23 | $1,317.28 |
| 2024 | 2,733 | 2,724 | $1,883.08 | $1,466.09 |
States with the most E2609 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Ohio | 383 | $1,419.15 |
| New York | 279 | $1,628.77 |
| California | 196 | $1,425.18 |
| Illinois | 195 | $1,479.43 |
| Texas | 191 | $1,406.32 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A52505: Wheelchair Seating - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for E2609
- 2005-01-01: E2609 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code E2609?
E2609 is the HCPCS Level II code for custom fabricated wheelchair seat cushion, any size. Short descriptor: "Custom fabricate w/c cushion".
How much does Medicare pay for E2609?
In 2024, the average Medicare payment was $1,466.09 per service (average allowed $1,883.08).
Does Medicare cover E2609?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of E2609 can be billed per day?
1 on DME suppliers (NCCI medically unlikely edits).
Related E26 codes
- E2601 — General use wheelchair seat cushion, width less than 22 inches, any depth ($4.46–$90.13)
- E2602 — General use wheelchair seat cushion, width 22 inches or greater, any depth ($9.50–$176.02)
- E2603 — Skin protection wheelchair seat cushion, width less than 22 inches, any depth ($11.52–$223.44)
- E2604 — Skin protection wheelchair seat cushion, width 22 inches or greater, any depth ($16.37–$277.75)
- E2605 — Positioning wheelchair seat cushion, width less than 22 inches, any depth ($24.43–$396.77)
- E2606 — Positioning wheelchair seat cushion, width 22 inches or greater, any depth ($38.83–$618.94)
- E2607 — Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth ($23.08–$427.26)
- E2608 — Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth ($29.66–$513.08)
- E2610 — Wheelchair seat cushion, powered
- E2611 — General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware ($18.00–$460.46)
- E2612 — General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware ($34.65–$622.81)
- E2613 — Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware ($35.41–$579.33)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under E2609
- Watch E2609 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E2609
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.