L0635
Prosthetics & Orthotics
53 States
Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment
Short Desc
Lso sagit rigid panel prefab
Coverage determined by local carrier discretion.
Added Date
2006-01-01
Effective From
2006-01-01
National Floor
$1,099.93
National Ceiling
$1,466.58
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$2,008.56
|
Same |
|
AL
|
Base Rate |
$1,313.90
|
Same |
|
AR
|
Base Rate |
$1,222.44
|
Same |
|
AZ
|
Base Rate |
$1,466.58
|
Same |
|
CA
|
Base Rate |
$1,466.58
|
Same |
|
CO
|
Base Rate |
$1,099.93
|
Same |
|
CT
|
Base Rate |
$1,123.96
|
Same |
|
DC
|
Base Rate |
$1,099.93
|
Same |
|
DE
|
Base Rate |
$1,099.93
|
Same |
|
FL
|
Base Rate |
$1,313.90
|
Same |
|
GA
|
Base Rate |
$1,313.90
|
Same |
|
HI
|
Base Rate |
$2,147.80
|
Same |
|
IA
|
Base Rate |
$1,229.97
|
Same |
|
ID
|
Base Rate |
$1,267.50
|
Same |
|
IL
|
Base Rate |
$1,228.02
|
Same |
|
IN
|
Base Rate |
$1,228.02
|
Same |
|
KS
|
Base Rate |
$1,229.97
|
Same |
|
KY
|
Base Rate |
$1,313.90
|
Same |
|
LA
|
Base Rate |
$1,222.44
|
Same |
|
MA
|
Base Rate |
$1,123.96
|
Same |
|
MD
|
Base Rate |
$1,099.93
|
Same |
|
ME
|
Base Rate |
$1,123.96
|
Same |
|
MI
|
Base Rate |
$1,228.02
|
Same |
|
MN
|
Base Rate |
$1,228.02
|
Same |
|
MO
|
Base Rate |
$1,229.97
|
Same |
|
MS
|
Base Rate |
$1,313.90
|
Same |
|
MT
|
Base Rate |
$1,099.93
|
Same |
|
NC
|
Base Rate |
$1,313.90
|
Same |
|
ND
|
Base Rate |
$1,099.93
|
Same |
|
NE
|
Base Rate |
$1,229.97
|
Same |
|
NH
|
Base Rate |
$1,123.96
|
Same |
|
NJ
|
Base Rate |
$1,169.32
|
Same |
|
NM
|
Base Rate |
$1,222.44
|
Same |
|
NV
|
Base Rate |
$1,466.58
|
Same |
|
NY
|
Base Rate |
$1,169.32
|
Same |
|
OH
|
Base Rate |
$1,228.02
|
Same |
|
OK
|
Base Rate |
$1,222.44
|
Same |
|
OR
|
Base Rate |
$1,267.50
|
Same |
|
PA
|
Base Rate |
$1,099.93
|
Same |
|
PR
|
Base Rate |
$1,309.07
|
Same |
|
RI
|
Base Rate |
$1,123.96
|
Same |
|
SC
|
Base Rate |
$1,313.90
|
Same |
|
SD
|
Base Rate |
$1,099.93
|
Same |
|
TN
|
Base Rate |
$1,313.90
|
Same |
|
TX
|
Base Rate |
$1,222.44
|
Same |
|
UT
|
Base Rate |
$1,099.93
|
Same |
|
VA
|
Base Rate |
$1,099.93
|
Same |
|
VI
|
Base Rate |
$1,169.32
|
Same |
|
VT
|
Base Rate |
$1,123.96
|
Same |
|
WA
|
Base Rate |
$1,267.50
|
Same |
|
WI
|
Base Rate |
$1,228.02
|
Same |
|
WV
|
Base Rate |
$1,099.93
|
Same |
|
WY
|
Base Rate |
$1,099.93
|
Same |