L5926
Prosthetics & Orthotics
53 States
Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type
Short Desc
Endoskel posit rotat unit
Coverage determined by local carrier discretion.
Added Date
2024-01-01
Effective From
2024-01-01
National Floor
$697.41
National Ceiling
$929.89
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$1,097.66
|
Same |
|
AL
|
Base Rate |
$697.41
|
Same |
|
AR
|
Base Rate |
$823.06
|
Same |
|
AZ
|
Base Rate |
$929.89
|
Same |
|
CA
|
Base Rate |
$929.89
|
Same |
|
CO
|
Base Rate |
$738.45
|
Same |
|
CT
|
Base Rate |
$847.46
|
Same |
|
DC
|
Base Rate |
$701.46
|
Same |
|
DE
|
Base Rate |
$701.46
|
Same |
|
FL
|
Base Rate |
$697.41
|
Same |
|
GA
|
Base Rate |
$697.41
|
Same |
|
HI
|
Base Rate |
$1,173.77
|
Same |
|
IA
|
Base Rate |
$817.24
|
Same |
|
ID
|
Base Rate |
$884.40
|
Same |
|
IL
|
Base Rate |
$791.74
|
Same |
|
IN
|
Base Rate |
$791.74
|
Same |
|
KS
|
Base Rate |
$817.24
|
Same |
|
KY
|
Base Rate |
$697.41
|
Same |
|
LA
|
Base Rate |
$823.06
|
Same |
|
MA
|
Base Rate |
$847.46
|
Same |
|
MD
|
Base Rate |
$701.46
|
Same |
|
ME
|
Base Rate |
$847.46
|
Same |
|
MI
|
Base Rate |
$791.74
|
Same |
|
MN
|
Base Rate |
$791.74
|
Same |
|
MO
|
Base Rate |
$817.24
|
Same |
|
MS
|
Base Rate |
$697.41
|
Same |
|
MT
|
Base Rate |
$738.45
|
Same |
|
NC
|
Base Rate |
$697.41
|
Same |
|
ND
|
Base Rate |
$738.45
|
Same |
|
NE
|
Base Rate |
$817.24
|
Same |
|
NH
|
Base Rate |
$847.46
|
Same |
|
NJ
|
Base Rate |
$697.41
|
Same |
|
NM
|
Base Rate |
$823.06
|
Same |
|
NV
|
Base Rate |
$929.89
|
Same |
|
NY
|
Base Rate |
$697.41
|
Same |
|
OH
|
Base Rate |
$791.74
|
Same |
|
OK
|
Base Rate |
$823.06
|
Same |
|
OR
|
Base Rate |
$884.40
|
Same |
|
PA
|
Base Rate |
$701.46
|
Same |
|
PR
|
Base Rate |
$494.92
|
Same |
|
RI
|
Base Rate |
$847.46
|
Same |
|
SC
|
Base Rate |
$697.41
|
Same |
|
SD
|
Base Rate |
$738.45
|
Same |
|
TN
|
Base Rate |
$697.41
|
Same |
|
TX
|
Base Rate |
$823.06
|
Same |
|
UT
|
Base Rate |
$738.45
|
Same |
|
VA
|
Base Rate |
$701.46
|
Same |
|
VI
|
Base Rate |
$697.41
|
Same |
|
VT
|
Base Rate |
$847.46
|
Same |
|
WA
|
Base Rate |
$884.40
|
Same |
|
WI
|
Base Rate |
$791.74
|
Same |
|
WV
|
Base Rate |
$701.46
|
Same |
|
WY
|
Base Rate |
$738.45
|
Same |