🔧 TEST VERSION • This is a preview of upcoming features
L5600 Prosthetics & Orthotics 53 States

Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model

Short Desc Hip disart sach laminat mold
Coverage determined by local carrier discretion.
Added Date
1989-01-01
Effective From
1996-01-01
National Floor
$5,443.57
National Ceiling
$7,258.09

Fee Schedule Rates

Effective Jan 2026

Official Medicare DMEPOS pricing for 2026.

State Modifier Non-Rural Rural
AK
Base Rate
$9,420.63
Same
AL
Base Rate
$5,588.93
Same
AR
Base Rate
$5,443.57
Same
AZ
Base Rate
$7,258.09
Same
CA
Base Rate
$7,258.09
Same
CO
Base Rate
$5,443.57
Same
CT
Base Rate
$7,159.07
Same
DC
Base Rate
$5,642.33
Same
DE
Base Rate
$5,642.33
Same
FL
Base Rate
$5,588.93
Same
GA
Base Rate
$5,588.93
Same
HI
Base Rate
$10,073.55
Same
IA
Base Rate
$5,493.81
Same
ID
Base Rate
$6,965.78
Same
IL
Base Rate
$6,421.23
Same
IN
Base Rate
$6,421.23
Same
KS
Base Rate
$5,493.81
Same
KY
Base Rate
$5,588.93
Same
LA
Base Rate
$5,443.57
Same
MA
Base Rate
$7,159.07
Same
MD
Base Rate
$5,642.33
Same
ME
Base Rate
$7,159.07
Same
MI
Base Rate
$6,421.23
Same
MN
Base Rate
$6,421.23
Same
MO
Base Rate
$5,493.81
Same
MS
Base Rate
$5,588.93
Same
MT
Base Rate
$5,443.57
Same
NC
Base Rate
$5,588.93
Same
ND
Base Rate
$5,443.57
Same
NE
Base Rate
$5,493.81
Same
NH
Base Rate
$7,159.07
Same
NJ
Base Rate
$6,020.12
Same
NM
Base Rate
$5,443.57
Same
NV
Base Rate
$7,258.09
Same
NY
Base Rate
$6,020.12
Same
OH
Base Rate
$6,421.23
Same
OK
Base Rate
$5,443.57
Same
OR
Base Rate
$6,965.78
Same
PA
Base Rate
$5,642.33
Same
PR
Base Rate
$8,565.94
Same
RI
Base Rate
$7,159.07
Same
SC
Base Rate
$5,588.93
Same
SD
Base Rate
$5,443.57
Same
TN
Base Rate
$5,588.93
Same
TX
Base Rate
$5,443.57
Same
UT
Base Rate
$5,443.57
Same
VA
Base Rate
$5,642.33
Same
VI
Base Rate
$6,020.12
Same
VT
Base Rate
$7,159.07
Same
WA
Base Rate
$6,965.78
Same
WI
Base Rate
$6,421.23
Same
WV
Base Rate
$5,642.33
Same
WY
Base Rate
$5,443.57
Same