L1900
Prosthetics & Orthotics
53 States
Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated
Short Desc
Afo sprng wir drsflx calf bd
Coverage determined by local carrier discretion.
Added Date
1986-01-01
Effective From
2001-01-01
National Floor
$310.01
National Ceiling
$413.34
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$347.44
|
Same |
|
AL
|
Base Rate |
$347.57
|
Same |
|
AR
|
Base Rate |
$398.09
|
Same |
|
AZ
|
Base Rate |
$350.66
|
Same |
|
CA
|
Base Rate |
$350.66
|
Same |
|
CO
|
Base Rate |
$338.06
|
Same |
|
CT
|
Base Rate |
$364.99
|
Same |
|
DC
|
Base Rate |
$310.01
|
Same |
|
DE
|
Base Rate |
$310.01
|
Same |
|
FL
|
Base Rate |
$347.57
|
Same |
|
GA
|
Base Rate |
$347.57
|
Same |
|
HI
|
Base Rate |
$371.47
|
Same |
|
IA
|
Base Rate |
$322.82
|
Same |
|
ID
|
Base Rate |
$341.79
|
Same |
|
IL
|
Base Rate |
$350.64
|
Same |
|
IN
|
Base Rate |
$350.64
|
Same |
|
KS
|
Base Rate |
$322.82
|
Same |
|
KY
|
Base Rate |
$347.57
|
Same |
|
LA
|
Base Rate |
$398.09
|
Same |
|
MA
|
Base Rate |
$364.99
|
Same |
|
MD
|
Base Rate |
$310.01
|
Same |
|
ME
|
Base Rate |
$364.99
|
Same |
|
MI
|
Base Rate |
$350.64
|
Same |
|
MN
|
Base Rate |
$350.64
|
Same |
|
MO
|
Base Rate |
$322.82
|
Same |
|
MS
|
Base Rate |
$347.57
|
Same |
|
MT
|
Base Rate |
$338.06
|
Same |
|
NC
|
Base Rate |
$347.57
|
Same |
|
ND
|
Base Rate |
$338.06
|
Same |
|
NE
|
Base Rate |
$322.82
|
Same |
|
NH
|
Base Rate |
$364.99
|
Same |
|
NJ
|
Base Rate |
$310.01
|
Same |
|
NM
|
Base Rate |
$398.09
|
Same |
|
NV
|
Base Rate |
$350.66
|
Same |
|
NY
|
Base Rate |
$310.01
|
Same |
|
OH
|
Base Rate |
$350.64
|
Same |
|
OK
|
Base Rate |
$398.09
|
Same |
|
OR
|
Base Rate |
$341.79
|
Same |
|
PA
|
Base Rate |
$310.01
|
Same |
|
PR
|
Base Rate |
$352.16
|
Same |
|
RI
|
Base Rate |
$364.99
|
Same |
|
SC
|
Base Rate |
$347.57
|
Same |
|
SD
|
Base Rate |
$338.06
|
Same |
|
TN
|
Base Rate |
$347.57
|
Same |
|
TX
|
Base Rate |
$398.09
|
Same |
|
UT
|
Base Rate |
$338.06
|
Same |
|
VA
|
Base Rate |
$310.01
|
Same |
|
VI
|
Base Rate |
$310.01
|
Same |
|
VT
|
Base Rate |
$364.99
|
Same |
|
WA
|
Base Rate |
$341.79
|
Same |
|
WI
|
Base Rate |
$350.64
|
Same |
|
WV
|
Base Rate |
$310.01
|
Same |
|
WY
|
Base Rate |
$338.06
|
Same |