L2126
Prosthetics & Orthotics
53 States
Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated
Short Desc
Kafo fem fx cast thermoplas
Coverage determined by local carrier discretion.
Added Date
1988-01-01
Effective From
2001-01-01
National Floor
$1,376.03
National Ceiling
$1,834.71
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$1,703.35
|
Same |
|
AL
|
Base Rate |
$1,563.58
|
Same |
|
AR
|
Base Rate |
$1,376.03
|
Same |
|
AZ
|
Base Rate |
$1,574.26
|
Same |
|
CA
|
Base Rate |
$1,574.26
|
Same |
|
CO
|
Base Rate |
$1,545.25
|
Same |
|
CT
|
Base Rate |
$1,650.11
|
Same |
|
DC
|
Base Rate |
$1,510.57
|
Same |
|
DE
|
Base Rate |
$1,510.57
|
Same |
|
FL
|
Base Rate |
$1,563.58
|
Same |
|
GA
|
Base Rate |
$1,563.58
|
Same |
|
HI
|
Base Rate |
$1,821.35
|
Same |
|
IA
|
Base Rate |
$1,376.03
|
Same |
|
ID
|
Base Rate |
$1,376.03
|
Same |
|
IL
|
Base Rate |
$1,569.24
|
Same |
|
IN
|
Base Rate |
$1,569.24
|
Same |
|
KS
|
Base Rate |
$1,376.03
|
Same |
|
KY
|
Base Rate |
$1,563.58
|
Same |
|
LA
|
Base Rate |
$1,376.03
|
Same |
|
MA
|
Base Rate |
$1,650.11
|
Same |
|
MD
|
Base Rate |
$1,510.57
|
Same |
|
ME
|
Base Rate |
$1,650.11
|
Same |
|
MI
|
Base Rate |
$1,569.24
|
Same |
|
MN
|
Base Rate |
$1,569.24
|
Same |
|
MO
|
Base Rate |
$1,376.03
|
Same |
|
MS
|
Base Rate |
$1,563.58
|
Same |
|
MT
|
Base Rate |
$1,545.25
|
Same |
|
NC
|
Base Rate |
$1,563.58
|
Same |
|
ND
|
Base Rate |
$1,545.25
|
Same |
|
NE
|
Base Rate |
$1,376.03
|
Same |
|
NH
|
Base Rate |
$1,650.11
|
Same |
|
NJ
|
Base Rate |
$1,834.71
|
Same |
|
NM
|
Base Rate |
$1,376.03
|
Same |
|
NV
|
Base Rate |
$1,574.26
|
Same |
|
NY
|
Base Rate |
$1,834.71
|
Same |
|
OH
|
Base Rate |
$1,569.24
|
Same |
|
OK
|
Base Rate |
$1,376.03
|
Same |
|
OR
|
Base Rate |
$1,376.03
|
Same |
|
PA
|
Base Rate |
$1,510.57
|
Same |
|
PR
|
Base Rate |
$1,618.03
|
Same |
|
RI
|
Base Rate |
$1,650.11
|
Same |
|
SC
|
Base Rate |
$1,563.58
|
Same |
|
SD
|
Base Rate |
$1,545.25
|
Same |
|
TN
|
Base Rate |
$1,563.58
|
Same |
|
TX
|
Base Rate |
$1,376.03
|
Same |
|
UT
|
Base Rate |
$1,545.25
|
Same |
|
VA
|
Base Rate |
$1,510.57
|
Same |
|
VI
|
Base Rate |
$1,834.71
|
Same |
|
VT
|
Base Rate |
$1,650.11
|
Same |
|
WA
|
Base Rate |
$1,376.03
|
Same |
|
WI
|
Base Rate |
$1,569.24
|
Same |
|
WV
|
Base Rate |
$1,510.57
|
Same |
|
WY
|
Base Rate |
$1,545.25
|
Same |