L2037
Prosthetics & Orthotics
53 States
Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated
Short Desc
Kafo plas sing free knee mol
Coverage determined by local carrier discretion.
Added Date
1989-01-01
Effective From
2006-01-01
National Floor
$1,913.97
National Ceiling
$2,551.96
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$2,633.45
|
Same |
|
AL
|
Base Rate |
$1,964.76
|
Same |
|
AR
|
Base Rate |
$1,913.97
|
Same |
|
AZ
|
Base Rate |
$2,551.96
|
Same |
|
CA
|
Base Rate |
$2,551.96
|
Same |
|
CO
|
Base Rate |
$1,913.97
|
Same |
|
CT
|
Base Rate |
$2,551.96
|
Same |
|
DC
|
Base Rate |
$2,061.21
|
Same |
|
DE
|
Base Rate |
$2,061.21
|
Same |
|
FL
|
Base Rate |
$1,964.76
|
Same |
|
GA
|
Base Rate |
$1,964.76
|
Same |
|
HI
|
Base Rate |
$2,816.02
|
Same |
|
IA
|
Base Rate |
$1,913.97
|
Same |
|
ID
|
Base Rate |
$2,269.05
|
Same |
|
IL
|
Base Rate |
$2,038.02
|
Same |
|
IN
|
Base Rate |
$2,038.02
|
Same |
|
KS
|
Base Rate |
$1,913.97
|
Same |
|
KY
|
Base Rate |
$1,964.76
|
Same |
|
LA
|
Base Rate |
$1,913.97
|
Same |
|
MA
|
Base Rate |
$2,551.96
|
Same |
|
MD
|
Base Rate |
$2,061.21
|
Same |
|
ME
|
Base Rate |
$2,551.96
|
Same |
|
MI
|
Base Rate |
$2,038.02
|
Same |
|
MN
|
Base Rate |
$2,038.02
|
Same |
|
MO
|
Base Rate |
$1,913.97
|
Same |
|
MS
|
Base Rate |
$1,964.76
|
Same |
|
MT
|
Base Rate |
$1,913.97
|
Same |
|
NC
|
Base Rate |
$1,964.76
|
Same |
|
ND
|
Base Rate |
$1,913.97
|
Same |
|
NE
|
Base Rate |
$1,913.97
|
Same |
|
NH
|
Base Rate |
$2,551.96
|
Same |
|
NJ
|
Base Rate |
$2,515.30
|
Same |
|
NM
|
Base Rate |
$1,913.97
|
Same |
|
NV
|
Base Rate |
$2,551.96
|
Same |
|
NY
|
Base Rate |
$2,515.30
|
Same |
|
OH
|
Base Rate |
$2,038.02
|
Same |
|
OK
|
Base Rate |
$1,913.97
|
Same |
|
OR
|
Base Rate |
$2,269.05
|
Same |
|
PA
|
Base Rate |
$2,061.21
|
Same |
|
PR
|
Base Rate |
$2,959.04
|
Same |
|
RI
|
Base Rate |
$2,551.96
|
Same |
|
SC
|
Base Rate |
$1,964.76
|
Same |
|
SD
|
Base Rate |
$1,913.97
|
Same |
|
TN
|
Base Rate |
$1,964.76
|
Same |
|
TX
|
Base Rate |
$1,913.97
|
Same |
|
UT
|
Base Rate |
$1,913.97
|
Same |
|
VA
|
Base Rate |
$2,061.21
|
Same |
|
VI
|
Base Rate |
$2,515.29
|
Same |
|
VT
|
Base Rate |
$2,551.96
|
Same |
|
WA
|
Base Rate |
$2,269.05
|
Same |
|
WI
|
Base Rate |
$2,038.02
|
Same |
|
WV
|
Base Rate |
$2,061.21
|
Same |
|
WY
|
Base Rate |
$1,913.97
|
Same |