L1652
Prosthetics & Orthotics
53 States
Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Short Desc
Ho bi thighcuffs w sprdr bar
Coverage determined by local carrier discretion.
Added Date
2003-01-01
Effective From
2024-10-01
National Floor
$391.35
National Ceiling
$521.80
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$427.56
|
Same |
|
AL
|
Base Rate |
$440.48
|
Same |
|
AR
|
Base Rate |
$440.44
|
Same |
|
AZ
|
Base Rate |
$427.56
|
Same |
|
CA
|
Base Rate |
$427.56
|
Same |
|
CO
|
Base Rate |
$442.89
|
Same |
|
CT
|
Base Rate |
$427.56
|
Same |
|
DC
|
Base Rate |
$427.56
|
Same |
|
DE
|
Base Rate |
$427.56
|
Same |
|
FL
|
Base Rate |
$440.48
|
Same |
|
GA
|
Base Rate |
$440.48
|
Same |
|
HI
|
Base Rate |
$427.56
|
Same |
|
IA
|
Base Rate |
$435.97
|
Same |
|
ID
|
Base Rate |
$427.56
|
Same |
|
IL
|
Base Rate |
$438.09
|
Same |
|
IN
|
Base Rate |
$438.09
|
Same |
|
KS
|
Base Rate |
$435.97
|
Same |
|
KY
|
Base Rate |
$440.48
|
Same |
|
LA
|
Base Rate |
$440.44
|
Same |
|
MA
|
Base Rate |
$427.56
|
Same |
|
MD
|
Base Rate |
$427.56
|
Same |
|
ME
|
Base Rate |
$427.56
|
Same |
|
MI
|
Base Rate |
$438.09
|
Same |
|
MN
|
Base Rate |
$438.09
|
Same |
|
MO
|
Base Rate |
$435.97
|
Same |
|
MS
|
Base Rate |
$440.48
|
Same |
|
MT
|
Base Rate |
$442.89
|
Same |
|
NC
|
Base Rate |
$440.48
|
Same |
|
ND
|
Base Rate |
$442.89
|
Same |
|
NE
|
Base Rate |
$435.97
|
Same |
|
NH
|
Base Rate |
$427.56
|
Same |
|
NJ
|
Base Rate |
$427.56
|
Same |
|
NM
|
Base Rate |
$440.44
|
Same |
|
NV
|
Base Rate |
$427.56
|
Same |
|
NY
|
Base Rate |
$427.56
|
Same |
|
OH
|
Base Rate |
$438.09
|
Same |
|
OK
|
Base Rate |
$440.44
|
Same |
|
OR
|
Base Rate |
$427.56
|
Same |
|
PA
|
Base Rate |
$427.56
|
Same |
|
PR
|
Base Rate |
$470.32
|
Same |
|
RI
|
Base Rate |
$427.56
|
Same |
|
SC
|
Base Rate |
$440.48
|
Same |
|
SD
|
Base Rate |
$442.89
|
Same |
|
TN
|
Base Rate |
$440.48
|
Same |
|
TX
|
Base Rate |
$440.44
|
Same |
|
UT
|
Base Rate |
$442.89
|
Same |
|
VA
|
Base Rate |
$427.56
|
Same |
|
VI
|
Base Rate |
$470.32
|
Same |
|
VT
|
Base Rate |
$427.56
|
Same |
|
WA
|
Base Rate |
$427.56
|
Same |
|
WI
|
Base Rate |
$438.09
|
Same |
|
WV
|
Base Rate |
$427.56
|
Same |
|
WY
|
Base Rate |
$442.89
|
Same |