L5230
Prosthetics & Orthotics
53 States
Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot
Short Desc
Fem focal defic constant fri
Coverage determined by local carrier discretion.
Added Date
1982-01-01
Effective From
1996-01-01
National Floor
$4,657.24
National Ceiling
$6,209.65
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$6,622.06
|
Same |
|
AL
|
Base Rate |
$4,657.24
|
Same |
|
AR
|
Base Rate |
$5,101.97
|
Same |
|
AZ
|
Base Rate |
$6,209.65
|
Same |
|
CA
|
Base Rate |
$6,209.65
|
Same |
|
CO
|
Base Rate |
$6,209.65
|
Same |
|
CT
|
Base Rate |
$4,886.40
|
Same |
|
DC
|
Base Rate |
$4,657.24
|
Same |
|
DE
|
Base Rate |
$4,657.24
|
Same |
|
FL
|
Base Rate |
$4,657.24
|
Same |
|
GA
|
Base Rate |
$4,657.24
|
Same |
|
HI
|
Base Rate |
$7,081.06
|
Same |
|
IA
|
Base Rate |
$4,969.86
|
Same |
|
ID
|
Base Rate |
$6,021.66
|
Same |
|
IL
|
Base Rate |
$5,871.76
|
Same |
|
IN
|
Base Rate |
$5,871.76
|
Same |
|
KS
|
Base Rate |
$4,969.86
|
Same |
|
KY
|
Base Rate |
$4,657.24
|
Same |
|
LA
|
Base Rate |
$5,101.97
|
Same |
|
MA
|
Base Rate |
$4,886.40
|
Same |
|
MD
|
Base Rate |
$4,657.24
|
Same |
|
ME
|
Base Rate |
$4,886.40
|
Same |
|
MI
|
Base Rate |
$5,871.76
|
Same |
|
MN
|
Base Rate |
$5,871.76
|
Same |
|
MO
|
Base Rate |
$4,969.86
|
Same |
|
MS
|
Base Rate |
$4,657.24
|
Same |
|
MT
|
Base Rate |
$6,209.65
|
Same |
|
NC
|
Base Rate |
$4,657.24
|
Same |
|
ND
|
Base Rate |
$6,209.65
|
Same |
|
NE
|
Base Rate |
$4,969.86
|
Same |
|
NH
|
Base Rate |
$4,886.40
|
Same |
|
NJ
|
Base Rate |
$4,657.24
|
Same |
|
NM
|
Base Rate |
$5,101.97
|
Same |
|
NV
|
Base Rate |
$6,209.65
|
Same |
|
NY
|
Base Rate |
$4,657.24
|
Same |
|
OH
|
Base Rate |
$5,871.76
|
Same |
|
OK
|
Base Rate |
$5,101.97
|
Same |
|
OR
|
Base Rate |
$6,021.66
|
Same |
|
PA
|
Base Rate |
$4,657.24
|
Same |
|
PR
|
Base Rate |
$4,758.83
|
Same |
|
RI
|
Base Rate |
$4,886.40
|
Same |
|
SC
|
Base Rate |
$4,657.24
|
Same |
|
SD
|
Base Rate |
$6,209.65
|
Same |
|
TN
|
Base Rate |
$4,657.24
|
Same |
|
TX
|
Base Rate |
$5,101.97
|
Same |
|
UT
|
Base Rate |
$6,209.65
|
Same |
|
VA
|
Base Rate |
$4,657.24
|
Same |
|
VI
|
Base Rate |
$4,657.24
|
Same |
|
VT
|
Base Rate |
$4,886.40
|
Same |
|
WA
|
Base Rate |
$6,021.66
|
Same |
|
WI
|
Base Rate |
$5,871.76
|
Same |
|
WV
|
Base Rate |
$4,657.24
|
Same |
|
WY
|
Base Rate |
$6,209.65
|
Same |