K0672
Prosthetics & Orthotics
53 States
Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each
Short Desc
Removable soft interface le
Coverage determined by local carrier discretion.
Added Date
2008-04-01
Effective From
2008-04-01
National Floor
$93.31
National Ceiling
$124.41
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$101.70
|
Same |
|
AL
|
Base Rate |
$104.76
|
Same |
|
AR
|
Base Rate |
$104.75
|
Same |
|
AZ
|
Base Rate |
$101.70
|
Same |
|
CA
|
Base Rate |
$101.70
|
Same |
|
CO
|
Base Rate |
$105.37
|
Same |
|
CT
|
Base Rate |
$101.70
|
Same |
|
DC
|
Base Rate |
$101.70
|
Same |
|
DE
|
Base Rate |
$101.70
|
Same |
|
FL
|
Base Rate |
$104.76
|
Same |
|
GA
|
Base Rate |
$104.76
|
Same |
|
HI
|
Base Rate |
$101.70
|
Same |
|
IA
|
Base Rate |
$103.68
|
Same |
|
ID
|
Base Rate |
$105.66
|
Same |
|
IL
|
Base Rate |
$104.22
|
Same |
|
IN
|
Base Rate |
$104.22
|
Same |
|
KS
|
Base Rate |
$103.68
|
Same |
|
KY
|
Base Rate |
$104.76
|
Same |
|
LA
|
Base Rate |
$104.75
|
Same |
|
MA
|
Base Rate |
$101.70
|
Same |
|
MD
|
Base Rate |
$101.70
|
Same |
|
ME
|
Base Rate |
$101.70
|
Same |
|
MI
|
Base Rate |
$104.22
|
Same |
|
MN
|
Base Rate |
$104.22
|
Same |
|
MO
|
Base Rate |
$103.68
|
Same |
|
MS
|
Base Rate |
$104.76
|
Same |
|
MT
|
Base Rate |
$105.37
|
Same |
|
NC
|
Base Rate |
$104.76
|
Same |
|
ND
|
Base Rate |
$105.37
|
Same |
|
NE
|
Base Rate |
$103.68
|
Same |
|
NH
|
Base Rate |
$101.70
|
Same |
|
NJ
|
Base Rate |
$101.70
|
Same |
|
NM
|
Base Rate |
$104.75
|
Same |
|
NV
|
Base Rate |
$101.70
|
Same |
|
NY
|
Base Rate |
$101.70
|
Same |
|
OH
|
Base Rate |
$104.22
|
Same |
|
OK
|
Base Rate |
$104.75
|
Same |
|
OR
|
Base Rate |
$105.66
|
Same |
|
PA
|
Base Rate |
$101.70
|
Same |
|
PR
|
Base Rate |
$111.87
|
Same |
|
RI
|
Base Rate |
$101.70
|
Same |
|
SC
|
Base Rate |
$104.76
|
Same |
|
SD
|
Base Rate |
$105.37
|
Same |
|
TN
|
Base Rate |
$104.76
|
Same |
|
TX
|
Base Rate |
$104.75
|
Same |
|
UT
|
Base Rate |
$105.37
|
Same |
|
VA
|
Base Rate |
$101.70
|
Same |
|
VI
|
Base Rate |
$111.87
|
Same |
|
VT
|
Base Rate |
$101.70
|
Same |
|
WA
|
Base Rate |
$105.66
|
Same |
|
WI
|
Base Rate |
$104.22
|
Same |
|
WV
|
Base Rate |
$101.70
|
Same |
|
WY
|
Base Rate |
$105.37
|
Same |