L5420
Prosthetics & Orthotics
53 States
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation
Short Desc
Postop dsg & 1 cast chg ak/d
Coverage determined by local carrier discretion.
Added Date
1982-01-01
Effective From
1996-01-01
National Floor
$1,860.88
National Ceiling
$2,481.17
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$2,514.87
|
Same |
|
AL
|
Base Rate |
$2,043.12
|
Same |
|
AR
|
Base Rate |
$2,235.96
|
Same |
|
AZ
|
Base Rate |
$2,481.17
|
Same |
|
CA
|
Base Rate |
$2,481.17
|
Same |
|
CO
|
Base Rate |
$2,092.85
|
Same |
|
CT
|
Base Rate |
$1,860.88
|
Same |
|
DC
|
Base Rate |
$1,860.88
|
Same |
|
DE
|
Base Rate |
$1,860.88
|
Same |
|
FL
|
Base Rate |
$2,043.12
|
Same |
|
GA
|
Base Rate |
$2,043.12
|
Same |
|
HI
|
Base Rate |
$2,689.16
|
Same |
|
IA
|
Base Rate |
$2,232.64
|
Same |
|
ID
|
Base Rate |
$1,977.47
|
Same |
|
IL
|
Base Rate |
$2,481.17
|
Same |
|
IN
|
Base Rate |
$2,481.17
|
Same |
|
KS
|
Base Rate |
$2,232.64
|
Same |
|
KY
|
Base Rate |
$2,043.12
|
Same |
|
LA
|
Base Rate |
$2,235.96
|
Same |
|
MA
|
Base Rate |
$1,860.88
|
Same |
|
MD
|
Base Rate |
$1,860.88
|
Same |
|
ME
|
Base Rate |
$1,860.88
|
Same |
|
MI
|
Base Rate |
$2,481.17
|
Same |
|
MN
|
Base Rate |
$2,481.17
|
Same |
|
MO
|
Base Rate |
$2,232.64
|
Same |
|
MS
|
Base Rate |
$2,043.12
|
Same |
|
MT
|
Base Rate |
$2,092.85
|
Same |
|
NC
|
Base Rate |
$2,043.12
|
Same |
|
ND
|
Base Rate |
$2,092.85
|
Same |
|
NE
|
Base Rate |
$2,232.64
|
Same |
|
NH
|
Base Rate |
$1,860.88
|
Same |
|
NJ
|
Base Rate |
$1,860.88
|
Same |
|
NM
|
Base Rate |
$2,235.96
|
Same |
|
NV
|
Base Rate |
$2,481.17
|
Same |
|
NY
|
Base Rate |
$1,860.88
|
Same |
|
OH
|
Base Rate |
$2,481.17
|
Same |
|
OK
|
Base Rate |
$2,235.96
|
Same |
|
OR
|
Base Rate |
$1,977.47
|
Same |
|
PA
|
Base Rate |
$1,860.88
|
Same |
|
PR
|
Base Rate |
$1,329.43
|
Same |
|
RI
|
Base Rate |
$1,860.88
|
Same |
|
SC
|
Base Rate |
$2,043.12
|
Same |
|
SD
|
Base Rate |
$2,092.85
|
Same |
|
TN
|
Base Rate |
$2,043.12
|
Same |
|
TX
|
Base Rate |
$2,235.96
|
Same |
|
UT
|
Base Rate |
$2,092.85
|
Same |
|
VA
|
Base Rate |
$1,860.88
|
Same |
|
VI
|
Base Rate |
$1,860.88
|
Same |
|
VT
|
Base Rate |
$1,860.88
|
Same |
|
WA
|
Base Rate |
$1,977.47
|
Same |
|
WI
|
Base Rate |
$2,481.17
|
Same |
|
WV
|
Base Rate |
$1,860.88
|
Same |
|
WY
|
Base Rate |
$2,092.85
|
Same |