L2624
Prosthetics & Orthotics
53 States
Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each
Short Desc
Hip adj flex ext abduct cont
Coverage determined by local carrier discretion.
Added Date
1988-01-01
Effective From
1996-01-01
National Floor
$380.52
National Ceiling
$507.36
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$819.52
|
Same |
|
AL
|
Base Rate |
$479.06
|
Same |
|
AR
|
Base Rate |
$408.59
|
Same |
|
AZ
|
Base Rate |
$507.36
|
Same |
|
CA
|
Base Rate |
$507.36
|
Same |
|
CO
|
Base Rate |
$380.52
|
Same |
|
CT
|
Base Rate |
$380.52
|
Same |
|
DC
|
Base Rate |
$380.52
|
Same |
|
DE
|
Base Rate |
$380.52
|
Same |
|
FL
|
Base Rate |
$479.06
|
Same |
|
GA
|
Base Rate |
$479.06
|
Same |
|
HI
|
Base Rate |
$876.33
|
Same |
|
IA
|
Base Rate |
$448.85
|
Same |
|
ID
|
Base Rate |
$380.52
|
Same |
|
IL
|
Base Rate |
$479.52
|
Same |
|
IN
|
Base Rate |
$479.52
|
Same |
|
KS
|
Base Rate |
$448.85
|
Same |
|
KY
|
Base Rate |
$479.06
|
Same |
|
LA
|
Base Rate |
$408.59
|
Same |
|
MA
|
Base Rate |
$380.52
|
Same |
|
MD
|
Base Rate |
$380.52
|
Same |
|
ME
|
Base Rate |
$380.52
|
Same |
|
MI
|
Base Rate |
$479.52
|
Same |
|
MN
|
Base Rate |
$479.52
|
Same |
|
MO
|
Base Rate |
$448.85
|
Same |
|
MS
|
Base Rate |
$479.06
|
Same |
|
MT
|
Base Rate |
$380.52
|
Same |
|
NC
|
Base Rate |
$479.06
|
Same |
|
ND
|
Base Rate |
$380.52
|
Same |
|
NE
|
Base Rate |
$448.85
|
Same |
|
NH
|
Base Rate |
$380.52
|
Same |
|
NJ
|
Base Rate |
$407.46
|
Same |
|
NM
|
Base Rate |
$408.59
|
Same |
|
NV
|
Base Rate |
$507.36
|
Same |
|
NY
|
Base Rate |
$407.46
|
Same |
|
OH
|
Base Rate |
$479.52
|
Same |
|
OK
|
Base Rate |
$408.59
|
Same |
|
OR
|
Base Rate |
$380.52
|
Same |
|
PA
|
Base Rate |
$380.52
|
Same |
|
PR
|
Base Rate |
$257.00
|
Same |
|
RI
|
Base Rate |
$380.52
|
Same |
|
SC
|
Base Rate |
$479.06
|
Same |
|
SD
|
Base Rate |
$380.52
|
Same |
|
TN
|
Base Rate |
$479.06
|
Same |
|
TX
|
Base Rate |
$408.59
|
Same |
|
UT
|
Base Rate |
$380.52
|
Same |
|
VA
|
Base Rate |
$380.52
|
Same |
|
VI
|
Base Rate |
$407.46
|
Same |
|
VT
|
Base Rate |
$380.52
|
Same |
|
WA
|
Base Rate |
$380.52
|
Same |
|
WI
|
Base Rate |
$479.52
|
Same |
|
WV
|
Base Rate |
$380.52
|
Same |
|
WY
|
Base Rate |
$380.52
|
Same |