L6580
Prosthetics & Orthotics
53 States
Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model
Short Desc
Wrist/elbow bowden cable mol
Coverage determined by local carrier discretion.
Added Date
1988-01-01
Effective From
1996-01-01
National Floor
$1,913.69
National Ceiling
$2,551.59
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$2,261.80
|
Same |
|
AL
|
Base Rate |
$2,045.72
|
Same |
|
AR
|
Base Rate |
$2,011.74
|
Same |
|
AZ
|
Base Rate |
$2,187.89
|
Same |
|
CA
|
Base Rate |
$2,187.89
|
Same |
|
CO
|
Base Rate |
$2,302.95
|
Same |
|
CT
|
Base Rate |
$1,985.81
|
Same |
|
DC
|
Base Rate |
$1,977.21
|
Same |
|
DE
|
Base Rate |
$1,977.21
|
Same |
|
FL
|
Base Rate |
$2,045.72
|
Same |
|
GA
|
Base Rate |
$2,045.72
|
Same |
|
HI
|
Base Rate |
$2,418.63
|
Same |
|
IA
|
Base Rate |
$2,059.23
|
Same |
|
ID
|
Base Rate |
$2,205.31
|
Same |
|
IL
|
Base Rate |
$2,486.04
|
Same |
|
IN
|
Base Rate |
$2,486.04
|
Same |
|
KS
|
Base Rate |
$2,059.23
|
Same |
|
KY
|
Base Rate |
$2,045.72
|
Same |
|
LA
|
Base Rate |
$2,011.74
|
Same |
|
MA
|
Base Rate |
$1,985.81
|
Same |
|
MD
|
Base Rate |
$1,977.21
|
Same |
|
ME
|
Base Rate |
$1,985.81
|
Same |
|
MI
|
Base Rate |
$2,486.04
|
Same |
|
MN
|
Base Rate |
$2,486.04
|
Same |
|
MO
|
Base Rate |
$2,059.23
|
Same |
|
MS
|
Base Rate |
$2,045.72
|
Same |
|
MT
|
Base Rate |
$2,302.95
|
Same |
|
NC
|
Base Rate |
$2,045.72
|
Same |
|
ND
|
Base Rate |
$2,302.95
|
Same |
|
NE
|
Base Rate |
$2,059.23
|
Same |
|
NH
|
Base Rate |
$1,985.81
|
Same |
|
NJ
|
Base Rate |
$1,918.42
|
Same |
|
NM
|
Base Rate |
$2,011.74
|
Same |
|
NV
|
Base Rate |
$2,187.89
|
Same |
|
NY
|
Base Rate |
$1,918.42
|
Same |
|
OH
|
Base Rate |
$2,486.04
|
Same |
|
OK
|
Base Rate |
$2,011.74
|
Same |
|
OR
|
Base Rate |
$2,205.31
|
Same |
|
PA
|
Base Rate |
$1,977.21
|
Same |
|
PR
|
Base Rate |
$1,918.41
|
Same |
|
RI
|
Base Rate |
$1,985.81
|
Same |
|
SC
|
Base Rate |
$2,045.72
|
Same |
|
SD
|
Base Rate |
$2,302.95
|
Same |
|
TN
|
Base Rate |
$2,045.72
|
Same |
|
TX
|
Base Rate |
$2,011.74
|
Same |
|
UT
|
Base Rate |
$2,302.95
|
Same |
|
VA
|
Base Rate |
$1,977.21
|
Same |
|
VI
|
Base Rate |
$1,918.42
|
Same |
|
VT
|
Base Rate |
$1,985.81
|
Same |
|
WA
|
Base Rate |
$2,205.31
|
Same |
|
WI
|
Base Rate |
$2,486.04
|
Same |
|
WV
|
Base Rate |
$1,977.21
|
Same |
|
WY
|
Base Rate |
$2,302.95
|
Same |