L5656
Prosthetics & Orthotics
53 States
Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)
Short Desc
Socket insert knee articulat
Coverage determined by local carrier discretion.
Added Date
1986-01-01
Effective From
1986-01-01
National Floor
$454.13
National Ceiling
$605.51
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$623.82
|
Same |
|
AL
|
Base Rate |
$461.57
|
Same |
|
AR
|
Base Rate |
$465.36
|
Same |
|
AZ
|
Base Rate |
$605.51
|
Same |
|
CA
|
Base Rate |
$605.51
|
Same |
|
CO
|
Base Rate |
$468.63
|
Same |
|
CT
|
Base Rate |
$458.53
|
Same |
|
DC
|
Base Rate |
$484.26
|
Same |
|
DE
|
Base Rate |
$484.26
|
Same |
|
FL
|
Base Rate |
$461.57
|
Same |
|
GA
|
Base Rate |
$461.57
|
Same |
|
HI
|
Base Rate |
$667.06
|
Same |
|
IA
|
Base Rate |
$514.58
|
Same |
|
ID
|
Base Rate |
$605.51
|
Same |
|
IL
|
Base Rate |
$529.54
|
Same |
|
IN
|
Base Rate |
$529.54
|
Same |
|
KS
|
Base Rate |
$514.58
|
Same |
|
KY
|
Base Rate |
$461.57
|
Same |
|
LA
|
Base Rate |
$465.36
|
Same |
|
MA
|
Base Rate |
$458.53
|
Same |
|
MD
|
Base Rate |
$484.26
|
Same |
|
ME
|
Base Rate |
$458.53
|
Same |
|
MI
|
Base Rate |
$529.54
|
Same |
|
MN
|
Base Rate |
$529.54
|
Same |
|
MO
|
Base Rate |
$514.58
|
Same |
|
MS
|
Base Rate |
$461.57
|
Same |
|
MT
|
Base Rate |
$468.63
|
Same |
|
NC
|
Base Rate |
$461.57
|
Same |
|
ND
|
Base Rate |
$468.63
|
Same |
|
NE
|
Base Rate |
$514.58
|
Same |
|
NH
|
Base Rate |
$458.53
|
Same |
|
NJ
|
Base Rate |
$593.52
|
Same |
|
NM
|
Base Rate |
$465.36
|
Same |
|
NV
|
Base Rate |
$605.51
|
Same |
|
NY
|
Base Rate |
$593.52
|
Same |
|
OH
|
Base Rate |
$529.54
|
Same |
|
OK
|
Base Rate |
$465.36
|
Same |
|
OR
|
Base Rate |
$605.51
|
Same |
|
PA
|
Base Rate |
$484.26
|
Same |
|
PR
|
Base Rate |
$648.52
|
Same |
|
RI
|
Base Rate |
$458.53
|
Same |
|
SC
|
Base Rate |
$461.57
|
Same |
|
SD
|
Base Rate |
$468.63
|
Same |
|
TN
|
Base Rate |
$461.57
|
Same |
|
TX
|
Base Rate |
$465.36
|
Same |
|
UT
|
Base Rate |
$468.63
|
Same |
|
VA
|
Base Rate |
$484.26
|
Same |
|
VI
|
Base Rate |
$593.50
|
Same |
|
VT
|
Base Rate |
$458.53
|
Same |
|
WA
|
Base Rate |
$605.51
|
Same |
|
WI
|
Base Rate |
$529.54
|
Same |
|
WV
|
Base Rate |
$484.26
|
Same |
|
WY
|
Base Rate |
$468.63
|
Same |