L0859
Prosthetics & Orthotics
53 States
Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material
Short Desc
Mri compatible system
Coverage determined by local carrier discretion.
Added Date
2006-01-01
Effective From
2006-01-01
National Floor
$1,399.89
National Ceiling
$1,866.53
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$1,256.43
|
Same |
|
AL
|
Base Rate |
$1,399.89
|
Same |
|
AR
|
Base Rate |
$1,866.53
|
Same |
|
AZ
|
Base Rate |
$1,399.89
|
Same |
|
CA
|
Base Rate |
$1,399.89
|
Same |
|
CO
|
Base Rate |
$1,866.53
|
Same |
|
CT
|
Base Rate |
$1,487.20
|
Same |
|
DC
|
Base Rate |
$1,582.21
|
Same |
|
DE
|
Base Rate |
$1,582.21
|
Same |
|
FL
|
Base Rate |
$1,399.89
|
Same |
|
GA
|
Base Rate |
$1,399.89
|
Same |
|
HI
|
Base Rate |
$1,343.50
|
Same |
|
IA
|
Base Rate |
$1,399.89
|
Same |
|
ID
|
Base Rate |
$1,399.89
|
Same |
|
IL
|
Base Rate |
$1,399.89
|
Same |
|
IN
|
Base Rate |
$1,399.89
|
Same |
|
KS
|
Base Rate |
$1,399.89
|
Same |
|
KY
|
Base Rate |
$1,399.89
|
Same |
|
LA
|
Base Rate |
$1,866.53
|
Same |
|
MA
|
Base Rate |
$1,487.20
|
Same |
|
MD
|
Base Rate |
$1,582.21
|
Same |
|
ME
|
Base Rate |
$1,487.20
|
Same |
|
MI
|
Base Rate |
$1,399.89
|
Same |
|
MN
|
Base Rate |
$1,399.89
|
Same |
|
MO
|
Base Rate |
$1,399.89
|
Same |
|
MS
|
Base Rate |
$1,399.89
|
Same |
|
MT
|
Base Rate |
$1,866.53
|
Same |
|
NC
|
Base Rate |
$1,399.89
|
Same |
|
ND
|
Base Rate |
$1,866.53
|
Same |
|
NE
|
Base Rate |
$1,399.89
|
Same |
|
NH
|
Base Rate |
$1,487.20
|
Same |
|
NJ
|
Base Rate |
$1,399.89
|
Same |
|
NM
|
Base Rate |
$1,866.53
|
Same |
|
NV
|
Base Rate |
$1,399.89
|
Same |
|
NY
|
Base Rate |
$1,399.89
|
Same |
|
OH
|
Base Rate |
$1,399.89
|
Same |
|
OK
|
Base Rate |
$1,866.53
|
Same |
|
OR
|
Base Rate |
$1,399.89
|
Same |
|
PA
|
Base Rate |
$1,582.21
|
Same |
|
PR
|
Base Rate |
$1,416.27
|
Same |
|
RI
|
Base Rate |
$1,487.20
|
Same |
|
SC
|
Base Rate |
$1,399.89
|
Same |
|
SD
|
Base Rate |
$1,866.53
|
Same |
|
TN
|
Base Rate |
$1,399.89
|
Same |
|
TX
|
Base Rate |
$1,866.53
|
Same |
|
UT
|
Base Rate |
$1,866.53
|
Same |
|
VA
|
Base Rate |
$1,582.21
|
Same |
|
VI
|
Base Rate |
$1,399.89
|
Same |
|
VT
|
Base Rate |
$1,487.20
|
Same |
|
WA
|
Base Rate |
$1,399.89
|
Same |
|
WI
|
Base Rate |
$1,399.89
|
Same |
|
WV
|
Base Rate |
$1,582.21
|
Same |
|
WY
|
Base Rate |
$1,866.53
|
Same |