L5645
Prosthetics & Orthotics
53 States
Addition to lower extremity, below knee, flexible inner socket, external frame
Short Desc
Bk flex inner socket ext fra
Coverage determined by local carrier discretion.
Added Date
1988-01-01
Effective From
2000-12-13
National Floor
$976.81
National Ceiling
$1,302.42
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$1,173.77
|
Same |
|
AL
|
Base Rate |
$976.81
|
Same |
|
AR
|
Base Rate |
$978.80
|
Same |
|
AZ
|
Base Rate |
$1,105.72
|
Same |
|
CA
|
Base Rate |
$1,105.72
|
Same |
|
CO
|
Base Rate |
$1,302.42
|
Same |
|
CT
|
Base Rate |
$1,087.90
|
Same |
|
DC
|
Base Rate |
$976.81
|
Same |
|
DE
|
Base Rate |
$976.81
|
Same |
|
FL
|
Base Rate |
$976.81
|
Same |
|
GA
|
Base Rate |
$976.81
|
Same |
|
HI
|
Base Rate |
$1,255.13
|
Same |
|
IA
|
Base Rate |
$976.81
|
Same |
|
ID
|
Base Rate |
$976.81
|
Same |
|
IL
|
Base Rate |
$1,199.56
|
Same |
|
IN
|
Base Rate |
$1,199.56
|
Same |
|
KS
|
Base Rate |
$976.81
|
Same |
|
KY
|
Base Rate |
$976.81
|
Same |
|
LA
|
Base Rate |
$978.80
|
Same |
|
MA
|
Base Rate |
$1,087.90
|
Same |
|
MD
|
Base Rate |
$976.81
|
Same |
|
ME
|
Base Rate |
$1,087.90
|
Same |
|
MI
|
Base Rate |
$1,199.56
|
Same |
|
MN
|
Base Rate |
$1,199.56
|
Same |
|
MO
|
Base Rate |
$976.81
|
Same |
|
MS
|
Base Rate |
$976.81
|
Same |
|
MT
|
Base Rate |
$1,302.42
|
Same |
|
NC
|
Base Rate |
$976.81
|
Same |
|
ND
|
Base Rate |
$1,302.42
|
Same |
|
NE
|
Base Rate |
$976.81
|
Same |
|
NH
|
Base Rate |
$1,087.90
|
Same |
|
NJ
|
Base Rate |
$976.81
|
Same |
|
NM
|
Base Rate |
$978.80
|
Same |
|
NV
|
Base Rate |
$1,105.72
|
Same |
|
NY
|
Base Rate |
$976.81
|
Same |
|
OH
|
Base Rate |
$1,199.56
|
Same |
|
OK
|
Base Rate |
$978.80
|
Same |
|
OR
|
Base Rate |
$976.81
|
Same |
|
PA
|
Base Rate |
$976.81
|
Same |
|
PR
|
Base Rate |
$809.00
|
Same |
|
RI
|
Base Rate |
$1,087.90
|
Same |
|
SC
|
Base Rate |
$976.81
|
Same |
|
SD
|
Base Rate |
$1,302.42
|
Same |
|
TN
|
Base Rate |
$976.81
|
Same |
|
TX
|
Base Rate |
$978.80
|
Same |
|
UT
|
Base Rate |
$1,302.42
|
Same |
|
VA
|
Base Rate |
$976.81
|
Same |
|
VI
|
Base Rate |
$976.81
|
Same |
|
VT
|
Base Rate |
$1,087.90
|
Same |
|
WA
|
Base Rate |
$976.81
|
Same |
|
WI
|
Base Rate |
$1,199.56
|
Same |
|
WV
|
Base Rate |
$976.81
|
Same |
|
WY
|
Base Rate |
$1,302.42
|
Same |