L5783
Prosthetics & Orthotics
53 States
Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)
Short Desc
Add low ext mec limb vol lam
Coverage determined by local carrier discretion.
Added Date
2024-04-01
Effective From
2025-10-01
National Floor
$2,835.06
National Ceiling
$3,780.08
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$3,150.07
|
Same |
|
AL
|
Base Rate |
$3,150.07
|
Same |
|
AR
|
Base Rate |
$3,150.07
|
Same |
|
AZ
|
Base Rate |
$3,150.07
|
Same |
|
CA
|
Base Rate |
$3,150.07
|
Same |
|
CO
|
Base Rate |
$3,150.07
|
Same |
|
CT
|
Base Rate |
$3,150.07
|
Same |
|
DC
|
Base Rate |
$3,150.07
|
Same |
|
DE
|
Base Rate |
$3,150.07
|
Same |
|
FL
|
Base Rate |
$3,150.07
|
Same |
|
GA
|
Base Rate |
$3,150.07
|
Same |
|
HI
|
Base Rate |
$3,150.07
|
Same |
|
IA
|
Base Rate |
$3,150.07
|
Same |
|
ID
|
Base Rate |
$3,150.07
|
Same |
|
IL
|
Base Rate |
$3,150.07
|
Same |
|
IN
|
Base Rate |
$3,150.07
|
Same |
|
KS
|
Base Rate |
$3,150.07
|
Same |
|
KY
|
Base Rate |
$3,150.07
|
Same |
|
LA
|
Base Rate |
$3,150.07
|
Same |
|
MA
|
Base Rate |
$3,150.07
|
Same |
|
MD
|
Base Rate |
$3,150.07
|
Same |
|
ME
|
Base Rate |
$3,150.07
|
Same |
|
MI
|
Base Rate |
$3,150.07
|
Same |
|
MN
|
Base Rate |
$3,150.07
|
Same |
|
MO
|
Base Rate |
$3,150.07
|
Same |
|
MS
|
Base Rate |
$3,150.07
|
Same |
|
MT
|
Base Rate |
$3,150.07
|
Same |
|
NC
|
Base Rate |
$3,150.07
|
Same |
|
ND
|
Base Rate |
$3,150.07
|
Same |
|
NE
|
Base Rate |
$3,150.07
|
Same |
|
NH
|
Base Rate |
$3,150.07
|
Same |
|
NJ
|
Base Rate |
$3,150.07
|
Same |
|
NM
|
Base Rate |
$3,150.07
|
Same |
|
NV
|
Base Rate |
$3,150.07
|
Same |
|
NY
|
Base Rate |
$3,150.07
|
Same |
|
OH
|
Base Rate |
$3,150.07
|
Same |
|
OK
|
Base Rate |
$3,150.07
|
Same |
|
OR
|
Base Rate |
$3,150.07
|
Same |
|
PA
|
Base Rate |
$3,150.07
|
Same |
|
PR
|
Base Rate |
$3,150.07
|
Same |
|
RI
|
Base Rate |
$3,150.07
|
Same |
|
SC
|
Base Rate |
$3,150.07
|
Same |
|
SD
|
Base Rate |
$3,150.07
|
Same |
|
TN
|
Base Rate |
$3,150.07
|
Same |
|
TX
|
Base Rate |
$3,150.07
|
Same |
|
UT
|
Base Rate |
$3,150.07
|
Same |
|
VA
|
Base Rate |
$3,150.07
|
Same |
|
VI
|
Base Rate |
$3,150.07
|
Same |
|
VT
|
Base Rate |
$3,150.07
|
Same |
|
WA
|
Base Rate |
$3,150.07
|
Same |
|
WI
|
Base Rate |
$3,150.07
|
Same |
|
WV
|
Base Rate |
$3,150.07
|
Same |
|
WY
|
Base Rate |
$3,150.07
|
Same |