L2830
Prosthetics & Orthotics
53 States
Addition to lower extremity orthosis, soft interface for molded plastic, above knee section
Short Desc
Soft interface above knee se
Coverage determined by local carrier discretion.
Added Date
1988-01-01
Effective From
1996-01-01
National Floor
$107.96
National Ceiling
$143.94
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$204.40
|
Same |
|
AL
|
Base Rate |
$112.21
|
Same |
|
AR
|
Base Rate |
$107.96
|
Same |
|
AZ
|
Base Rate |
$143.94
|
Same |
|
CA
|
Base Rate |
$143.94
|
Same |
|
CO
|
Base Rate |
$143.94
|
Same |
|
CT
|
Base Rate |
$143.94
|
Same |
|
DC
|
Base Rate |
$107.96
|
Same |
|
DE
|
Base Rate |
$107.96
|
Same |
|
FL
|
Base Rate |
$112.21
|
Same |
|
GA
|
Base Rate |
$112.21
|
Same |
|
HI
|
Base Rate |
$218.59
|
Same |
|
IA
|
Base Rate |
$107.96
|
Same |
|
ID
|
Base Rate |
$107.96
|
Same |
|
IL
|
Base Rate |
$107.96
|
Same |
|
IN
|
Base Rate |
$107.96
|
Same |
|
KS
|
Base Rate |
$107.96
|
Same |
|
KY
|
Base Rate |
$112.21
|
Same |
|
LA
|
Base Rate |
$107.96
|
Same |
|
MA
|
Base Rate |
$143.94
|
Same |
|
MD
|
Base Rate |
$107.96
|
Same |
|
ME
|
Base Rate |
$143.94
|
Same |
|
MI
|
Base Rate |
$107.96
|
Same |
|
MN
|
Base Rate |
$107.96
|
Same |
|
MO
|
Base Rate |
$107.96
|
Same |
|
MS
|
Base Rate |
$112.21
|
Same |
|
MT
|
Base Rate |
$143.94
|
Same |
|
NC
|
Base Rate |
$112.21
|
Same |
|
ND
|
Base Rate |
$143.94
|
Same |
|
NE
|
Base Rate |
$107.96
|
Same |
|
NH
|
Base Rate |
$143.94
|
Same |
|
NJ
|
Base Rate |
$132.94
|
Same |
|
NM
|
Base Rate |
$107.96
|
Same |
|
NV
|
Base Rate |
$143.94
|
Same |
|
NY
|
Base Rate |
$132.94
|
Same |
|
OH
|
Base Rate |
$107.96
|
Same |
|
OK
|
Base Rate |
$107.96
|
Same |
|
OR
|
Base Rate |
$107.96
|
Same |
|
PA
|
Base Rate |
$107.96
|
Same |
|
PR
|
Base Rate |
$399.72
|
Same |
|
RI
|
Base Rate |
$143.94
|
Same |
|
SC
|
Base Rate |
$112.21
|
Same |
|
SD
|
Base Rate |
$143.94
|
Same |
|
TN
|
Base Rate |
$112.21
|
Same |
|
TX
|
Base Rate |
$107.96
|
Same |
|
UT
|
Base Rate |
$143.94
|
Same |
|
VA
|
Base Rate |
$107.96
|
Same |
|
VI
|
Base Rate |
$132.93
|
Same |
|
VT
|
Base Rate |
$143.94
|
Same |
|
WA
|
Base Rate |
$107.96
|
Same |
|
WI
|
Base Rate |
$107.96
|
Same |
|
WV
|
Base Rate |
$107.96
|
Same |
|
WY
|
Base Rate |
$143.94
|
Same |