L2005
Prosthetics & Orthotics
53 States
Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated
Short Desc
Kafo sng/dbl mechanical act
Coverage determined by local carrier discretion.
Added Date
2005-01-01
Effective From
2012-01-01
National Floor
$4,499.86
National Ceiling
$5,999.81
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$4,915.21
|
Same |
|
AL
|
Base Rate |
$5,063.24
|
Same |
|
AR
|
Base Rate |
$5,062.71
|
Same |
|
AZ
|
Base Rate |
$4,915.21
|
Same |
|
CA
|
Base Rate |
$4,915.21
|
Same |
|
CO
|
Base Rate |
$5,101.37
|
Same |
|
CT
|
Base Rate |
$4,915.21
|
Same |
|
DC
|
Base Rate |
$4,915.21
|
Same |
|
DE
|
Base Rate |
$4,915.21
|
Same |
|
FL
|
Base Rate |
$5,063.24
|
Same |
|
GA
|
Base Rate |
$5,063.24
|
Same |
|
HI
|
Base Rate |
$4,915.21
|
Same |
|
IA
|
Base Rate |
$5,011.19
|
Same |
|
ID
|
Base Rate |
$4,915.21
|
Same |
|
IL
|
Base Rate |
$5,035.93
|
Same |
|
IN
|
Base Rate |
$5,035.93
|
Same |
|
KS
|
Base Rate |
$5,011.19
|
Same |
|
KY
|
Base Rate |
$5,063.24
|
Same |
|
LA
|
Base Rate |
$5,062.71
|
Same |
|
MA
|
Base Rate |
$4,915.21
|
Same |
|
MD
|
Base Rate |
$4,915.21
|
Same |
|
ME
|
Base Rate |
$4,915.21
|
Same |
|
MI
|
Base Rate |
$5,035.93
|
Same |
|
MN
|
Base Rate |
$5,035.93
|
Same |
|
MO
|
Base Rate |
$5,011.19
|
Same |
|
MS
|
Base Rate |
$5,063.24
|
Same |
|
MT
|
Base Rate |
$5,101.37
|
Same |
|
NC
|
Base Rate |
$5,063.24
|
Same |
|
ND
|
Base Rate |
$5,101.37
|
Same |
|
NE
|
Base Rate |
$5,011.19
|
Same |
|
NH
|
Base Rate |
$4,915.21
|
Same |
|
NJ
|
Base Rate |
$4,915.21
|
Same |
|
NM
|
Base Rate |
$5,062.71
|
Same |
|
NV
|
Base Rate |
$4,915.21
|
Same |
|
NY
|
Base Rate |
$4,915.21
|
Same |
|
OH
|
Base Rate |
$5,035.93
|
Same |
|
OK
|
Base Rate |
$5,062.71
|
Same |
|
OR
|
Base Rate |
$4,915.21
|
Same |
|
PA
|
Base Rate |
$4,915.21
|
Same |
|
PR
|
Base Rate |
$5,406.75
|
Same |
|
RI
|
Base Rate |
$4,915.21
|
Same |
|
SC
|
Base Rate |
$5,063.24
|
Same |
|
SD
|
Base Rate |
$5,101.37
|
Same |
|
TN
|
Base Rate |
$5,063.24
|
Same |
|
TX
|
Base Rate |
$5,062.71
|
Same |
|
UT
|
Base Rate |
$5,101.37
|
Same |
|
VA
|
Base Rate |
$4,915.21
|
Same |
|
VI
|
Base Rate |
$5,406.75
|
Same |
|
VT
|
Base Rate |
$4,915.21
|
Same |
|
WA
|
Base Rate |
$4,915.21
|
Same |
|
WI
|
Base Rate |
$5,035.93
|
Same |
|
WV
|
Base Rate |
$4,915.21
|
Same |
|
WY
|
Base Rate |
$5,101.37
|
Same |