L5312
Prosthetics & Orthotics
53 States
Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system
Short Desc
Knee disart, sach ft, endo
Coverage determined by local carrier discretion.
Added Date
2012-01-01
Effective From
2012-01-01
National Floor
$4,038.17
National Ceiling
$5,384.23
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$4,831.27
|
Same |
|
AL
|
Base Rate |
$4,820.42
|
Same |
|
AR
|
Base Rate |
$4,506.48
|
Same |
|
AZ
|
Base Rate |
$4,823.95
|
Same |
|
CA
|
Base Rate |
$4,823.95
|
Same |
|
CO
|
Base Rate |
$4,464.92
|
Same |
|
CT
|
Base Rate |
$4,038.17
|
Same |
|
DC
|
Base Rate |
$4,038.17
|
Same |
|
DE
|
Base Rate |
$4,038.17
|
Same |
|
FL
|
Base Rate |
$4,820.42
|
Same |
|
GA
|
Base Rate |
$4,820.42
|
Same |
|
HI
|
Base Rate |
$5,252.85
|
Same |
|
IA
|
Base Rate |
$4,793.79
|
Same |
|
ID
|
Base Rate |
$5,384.23
|
Same |
|
IL
|
Base Rate |
$5,197.83
|
Same |
|
IN
|
Base Rate |
$5,197.83
|
Same |
|
KS
|
Base Rate |
$4,793.79
|
Same |
|
KY
|
Base Rate |
$4,820.42
|
Same |
|
LA
|
Base Rate |
$4,506.48
|
Same |
|
MA
|
Base Rate |
$4,038.17
|
Same |
|
MD
|
Base Rate |
$4,038.17
|
Same |
|
ME
|
Base Rate |
$4,038.17
|
Same |
|
MI
|
Base Rate |
$5,197.83
|
Same |
|
MN
|
Base Rate |
$5,197.83
|
Same |
|
MO
|
Base Rate |
$4,793.79
|
Same |
|
MS
|
Base Rate |
$4,820.42
|
Same |
|
MT
|
Base Rate |
$4,464.92
|
Same |
|
NC
|
Base Rate |
$4,820.42
|
Same |
|
ND
|
Base Rate |
$4,464.92
|
Same |
|
NE
|
Base Rate |
$4,793.79
|
Same |
|
NH
|
Base Rate |
$4,038.17
|
Same |
|
NJ
|
Base Rate |
$4,108.11
|
Same |
|
NM
|
Base Rate |
$4,506.48
|
Same |
|
NV
|
Base Rate |
$4,823.95
|
Same |
|
NY
|
Base Rate |
$4,108.11
|
Same |
|
OH
|
Base Rate |
$5,197.83
|
Same |
|
OK
|
Base Rate |
$4,506.48
|
Same |
|
OR
|
Base Rate |
$5,384.23
|
Same |
|
PA
|
Base Rate |
$4,038.17
|
Same |
|
PR
|
Base Rate |
$3,936.65
|
Same |
|
RI
|
Base Rate |
$4,038.17
|
Same |
|
SC
|
Base Rate |
$4,820.42
|
Same |
|
SD
|
Base Rate |
$4,464.92
|
Same |
|
TN
|
Base Rate |
$4,820.42
|
Same |
|
TX
|
Base Rate |
$4,506.48
|
Same |
|
UT
|
Base Rate |
$4,464.92
|
Same |
|
VA
|
Base Rate |
$4,038.17
|
Same |
|
VI
|
Base Rate |
$4,038.17
|
Same |
|
VT
|
Base Rate |
$4,038.17
|
Same |
|
WA
|
Base Rate |
$5,384.23
|
Same |
|
WI
|
Base Rate |
$5,197.83
|
Same |
|
WV
|
Base Rate |
$4,038.17
|
Same |
|
WY
|
Base Rate |
$4,464.92
|
Same |