L5616
Prosthetics & Orthotics
53 States
Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control
Short Desc
Ak univ multiplex sys frict
Coverage determined by local carrier discretion.
Added Date
1986-01-01
Effective From
1996-01-01
National Floor
$1,662.72
National Ceiling
$2,216.96
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$1,735.04
|
Same |
|
AL
|
Base Rate |
$1,666.52
|
Same |
|
AR
|
Base Rate |
$2,216.96
|
Same |
|
AZ
|
Base Rate |
$1,727.71
|
Same |
|
CA
|
Base Rate |
$1,727.71
|
Same |
|
CO
|
Base Rate |
$2,183.29
|
Same |
|
CT
|
Base Rate |
$1,877.09
|
Same |
|
DC
|
Base Rate |
$1,662.72
|
Same |
|
DE
|
Base Rate |
$1,662.72
|
Same |
|
FL
|
Base Rate |
$1,666.52
|
Same |
|
GA
|
Base Rate |
$1,666.52
|
Same |
|
HI
|
Base Rate |
$1,855.23
|
Same |
|
IA
|
Base Rate |
$1,946.80
|
Same |
|
ID
|
Base Rate |
$1,662.72
|
Same |
|
IL
|
Base Rate |
$1,809.06
|
Same |
|
IN
|
Base Rate |
$1,809.06
|
Same |
|
KS
|
Base Rate |
$1,946.80
|
Same |
|
KY
|
Base Rate |
$1,666.52
|
Same |
|
LA
|
Base Rate |
$2,216.96
|
Same |
|
MA
|
Base Rate |
$1,877.09
|
Same |
|
MD
|
Base Rate |
$1,662.72
|
Same |
|
ME
|
Base Rate |
$1,877.09
|
Same |
|
MI
|
Base Rate |
$1,809.06
|
Same |
|
MN
|
Base Rate |
$1,809.06
|
Same |
|
MO
|
Base Rate |
$1,946.80
|
Same |
|
MS
|
Base Rate |
$1,666.52
|
Same |
|
MT
|
Base Rate |
$2,183.29
|
Same |
|
NC
|
Base Rate |
$1,666.52
|
Same |
|
ND
|
Base Rate |
$2,183.29
|
Same |
|
NE
|
Base Rate |
$1,946.80
|
Same |
|
NH
|
Base Rate |
$1,877.09
|
Same |
|
NJ
|
Base Rate |
$1,662.72
|
Same |
|
NM
|
Base Rate |
$2,216.96
|
Same |
|
NV
|
Base Rate |
$1,727.71
|
Same |
|
NY
|
Base Rate |
$1,662.72
|
Same |
|
OH
|
Base Rate |
$1,809.06
|
Same |
|
OK
|
Base Rate |
$2,216.96
|
Same |
|
OR
|
Base Rate |
$1,662.72
|
Same |
|
PA
|
Base Rate |
$1,662.72
|
Same |
|
PR
|
Base Rate |
$1,427.66
|
Same |
|
RI
|
Base Rate |
$1,877.09
|
Same |
|
SC
|
Base Rate |
$1,666.52
|
Same |
|
SD
|
Base Rate |
$2,183.29
|
Same |
|
TN
|
Base Rate |
$1,666.52
|
Same |
|
TX
|
Base Rate |
$2,216.96
|
Same |
|
UT
|
Base Rate |
$2,183.29
|
Same |
|
VA
|
Base Rate |
$1,662.72
|
Same |
|
VI
|
Base Rate |
$1,662.72
|
Same |
|
VT
|
Base Rate |
$1,877.09
|
Same |
|
WA
|
Base Rate |
$1,662.72
|
Same |
|
WI
|
Base Rate |
$1,809.06
|
Same |
|
WV
|
Base Rate |
$1,662.72
|
Same |
|
WY
|
Base Rate |
$2,183.29
|
Same |