Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf

Short Desc Who cock-up nonmolde pre ots

Coverage determined by local carrier discretion.

Added Date

1986-01-01

Effective From

2014-01-01

National Floor

$67.37

National Ceiling

$89.82

Fee Schedule Rates

Effective Jan 2026

Official Medicare DMEPOS pricing for 2026.

Showing Non-Rural and Rural rates.

State	Modifier	Non-Rural	Rural
AK Alaska	Base Rate	$117.64	Same
AL Alabama	Base Rate	$67.37	Same
AR Arkansas	Base Rate	$67.37	Same
AZ Arizona	Base Rate	$89.82	Same
CA California	Base Rate	$89.82	Same
CO Colorado	Base Rate	$67.37	Same
CT Connecticut	Base Rate	$89.82	Same
DC District Of Columbia	Base Rate	$75.64	Same
DE Delaware	Base Rate	$75.64	Same
FL Florida	Base Rate	$67.37	Same
GA Georgia	Base Rate	$67.37	Same
HI Hawaii	Base Rate	$125.86	Same
IA Iowa	Base Rate	$68.45	Same
ID Idaho	Base Rate	$89.82	Same
IL Illinois	Base Rate	$82.00	Same
IN Indiana	Base Rate	$82.00	Same
KS Kansas	Base Rate	$68.45	Same
KY Kentucky	Base Rate	$67.37	Same
LA Louisiana	Base Rate	$67.37	Same
MA Massachusetts	Base Rate	$89.82	Same
MD Maryland	Base Rate	$75.64	Same
ME Maine	Base Rate	$89.82	Same
MI Michigan	Base Rate	$82.00	Same
MN Minnesota	Base Rate	$82.00	Same
MO Missouri	Base Rate	$68.45	Same
MS Mississippi	Base Rate	$67.37	Same
MT Montana	Base Rate	$67.37	Same
NC North Carolina	Base Rate	$67.37	Same
ND North Dakota	Base Rate	$67.37	Same
NE Nebraska	Base Rate	$68.45	Same
NH New Hampshire	Base Rate	$89.82	Same
NJ New Jersey	Base Rate	$89.82	Same
NM New Mexico	Base Rate	$67.37	Same
NV Nevada	Base Rate	$89.82	Same
NY New York	Base Rate	$89.82	Same
OH Ohio	Base Rate	$82.00	Same
OK Oklahoma	Base Rate	$67.37	Same
OR Oregon	Base Rate	$89.82	Same
PA Pennsylvania	Base Rate	$75.64	Same
PR Puerto Rico	Base Rate	$49.93	Same
RI Rhode Island	Base Rate	$89.82	Same
SC South Carolina	Base Rate	$67.37	Same
SD South Dakota	Base Rate	$67.37	Same
TN Tennessee	Base Rate	$67.37	Same
TX Texas	Base Rate	$67.37	Same
UT Utah	Base Rate	$67.37	Same
VA Virginia	Base Rate	$75.64	Same
VI Virgin Islands	Base Rate	$89.82	Same
VT Vermont	Base Rate	$89.82	Same
WA Washington	Base Rate	$89.82	Same
WI Wisconsin	Base Rate	$82.00	Same
WV West Virginia	Base Rate	$75.64	Same
WY Wyoming	Base Rate	$67.37	Same