L6646
Prosthetics & Orthotics
53 States
Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system
Short Desc
Multipo locking shoulder jnt
Coverage determined by local carrier discretion.
Added Date
2003-01-01
Effective From
2003-01-01
National Floor
$3,469.41
National Ceiling
$4,625.88
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$3,790.61
|
Same |
|
AL
|
Base Rate |
$3,904.74
|
Same |
|
AR
|
Base Rate |
$3,904.35
|
Same |
|
AZ
|
Base Rate |
$3,790.61
|
Same |
|
CA
|
Base Rate |
$3,790.61
|
Same |
|
CO
|
Base Rate |
$3,926.30
|
Same |
|
CT
|
Base Rate |
$3,790.61
|
Same |
|
DC
|
Base Rate |
$3,790.61
|
Same |
|
DE
|
Base Rate |
$3,790.61
|
Same |
|
FL
|
Base Rate |
$3,904.74
|
Same |
|
GA
|
Base Rate |
$3,904.74
|
Same |
|
HI
|
Base Rate |
$3,790.61
|
Same |
|
IA
|
Base Rate |
$3,864.58
|
Same |
|
ID
|
Base Rate |
$3,790.61
|
Same |
|
IL
|
Base Rate |
$3,883.70
|
Same |
|
IN
|
Base Rate |
$3,883.70
|
Same |
|
KS
|
Base Rate |
$3,864.58
|
Same |
|
KY
|
Base Rate |
$3,904.74
|
Same |
|
LA
|
Base Rate |
$3,904.35
|
Same |
|
MA
|
Base Rate |
$3,790.61
|
Same |
|
MD
|
Base Rate |
$3,790.61
|
Same |
|
ME
|
Base Rate |
$3,790.61
|
Same |
|
MI
|
Base Rate |
$3,883.70
|
Same |
|
MN
|
Base Rate |
$3,883.70
|
Same |
|
MO
|
Base Rate |
$3,864.58
|
Same |
|
MS
|
Base Rate |
$3,904.74
|
Same |
|
MT
|
Base Rate |
$3,926.30
|
Same |
|
NC
|
Base Rate |
$3,904.74
|
Same |
|
ND
|
Base Rate |
$3,926.30
|
Same |
|
NE
|
Base Rate |
$3,864.58
|
Same |
|
NH
|
Base Rate |
$3,790.61
|
Same |
|
NJ
|
Base Rate |
$3,790.61
|
Same |
|
NM
|
Base Rate |
$3,904.35
|
Same |
|
NV
|
Base Rate |
$3,790.61
|
Same |
|
NY
|
Base Rate |
$3,790.61
|
Same |
|
OH
|
Base Rate |
$3,883.70
|
Same |
|
OK
|
Base Rate |
$3,904.35
|
Same |
|
OR
|
Base Rate |
$3,790.61
|
Same |
|
PA
|
Base Rate |
$3,790.61
|
Same |
|
PR
|
Base Rate |
$4,169.67
|
Same |
|
RI
|
Base Rate |
$3,790.61
|
Same |
|
SC
|
Base Rate |
$3,904.74
|
Same |
|
SD
|
Base Rate |
$3,926.30
|
Same |
|
TN
|
Base Rate |
$3,904.74
|
Same |
|
TX
|
Base Rate |
$3,904.35
|
Same |
|
UT
|
Base Rate |
$3,926.30
|
Same |
|
VA
|
Base Rate |
$3,790.61
|
Same |
|
VI
|
Base Rate |
$4,169.67
|
Same |
|
VT
|
Base Rate |
$3,790.61
|
Same |
|
WA
|
Base Rate |
$3,790.61
|
Same |
|
WI
|
Base Rate |
$3,883.70
|
Same |
|
WV
|
Base Rate |
$3,790.61
|
Same |
|
WY
|
Base Rate |
$3,926.30
|
Same |