Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated

Short Desc Lso sag rigid frame cust

Coverage determined by local carrier discretion.

Added Date

2006-01-01

Effective From

2006-01-01

Fee Schedule Rates

Effective Jan 2026

Official Medicare DMEPOS pricing for 2026.

Showing Non-Rural and Rural rates.

State	Modifier	Non-Rural	Rural
AK Alaska	Base Rate	$0.00	Same
AL Alabama	Base Rate	$0.00	Same
AR Arkansas	Base Rate	$0.00	Same
AZ Arizona	Base Rate	$0.00	Same
CA California	Base Rate	$0.00	Same
CO Colorado	Base Rate	$0.00	Same
CT Connecticut	Base Rate	$0.00	Same
DC District Of Columbia	Base Rate	$0.00	Same
DE Delaware	Base Rate	$0.00	Same
FL Florida	Base Rate	$0.00	Same
GA Georgia	Base Rate	$0.00	Same
HI Hawaii	Base Rate	$0.00	Same
IA Iowa	Base Rate	$0.00	Same
ID Idaho	Base Rate	$0.00	Same
IL Illinois	Base Rate	$0.00	Same
IN Indiana	Base Rate	$0.00	Same
KS Kansas	Base Rate	$0.00	Same
KY Kentucky	Base Rate	$0.00	Same
LA Louisiana	Base Rate	$0.00	Same
MA Massachusetts	Base Rate	$0.00	Same
MD Maryland	Base Rate	$0.00	Same
ME Maine	Base Rate	$0.00	Same
MI Michigan	Base Rate	$0.00	Same
MN Minnesota	Base Rate	$0.00	Same
MO Missouri	Base Rate	$0.00	Same
MS Mississippi	Base Rate	$0.00	Same
MT Montana	Base Rate	$0.00	Same
NC North Carolina	Base Rate	$0.00	Same
ND North Dakota	Base Rate	$0.00	Same
NE Nebraska	Base Rate	$0.00	Same
NH New Hampshire	Base Rate	$0.00	Same
NJ New Jersey	Base Rate	$0.00	Same
NM New Mexico	Base Rate	$0.00	Same
NV Nevada	Base Rate	$0.00	Same
NY New York	Base Rate	$0.00	Same
OH Ohio	Base Rate	$0.00	Same
OK Oklahoma	Base Rate	$0.00	Same
OR Oregon	Base Rate	$0.00	Same
PA Pennsylvania	Base Rate	$0.00	Same
PR Puerto Rico	Base Rate	$0.00	Same
RI Rhode Island	Base Rate	$0.00	Same
SC South Carolina	Base Rate	$0.00	Same
SD South Dakota	Base Rate	$0.00	Same
TN Tennessee	Base Rate	$0.00	Same
TX Texas	Base Rate	$0.00	Same
UT Utah	Base Rate	$0.00	Same
VA Virginia	Base Rate	$0.00	Same
VI Virgin Islands	Base Rate	$0.00	Same
VT Vermont	Base Rate	$0.00	Same
WA Washington	Base Rate	$0.00	Same
WI Wisconsin	Base Rate	$0.00	Same
WV West Virginia	Base Rate	$0.00	Same
WY Wyoming	Base Rate	$0.00	Same