L6905
Prosthetics & Orthotics
53 States
Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining
Short Desc
Hand restoration multiple fi
Coverage determined by local carrier discretion.
Added Date
1986-01-01
Effective From
1996-01-01
National Floor
$1,797.45
National Ceiling
$2,396.60
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$2,694.24
|
Same |
|
AL
|
Base Rate |
$2,173.60
|
Same |
|
AR
|
Base Rate |
$1,797.45
|
Same |
|
AZ
|
Base Rate |
$2,396.60
|
Same |
|
CA
|
Base Rate |
$2,396.60
|
Same |
|
CO
|
Base Rate |
$1,797.45
|
Same |
|
CT
|
Base Rate |
$1,797.45
|
Same |
|
DC
|
Base Rate |
$1,930.97
|
Same |
|
DE
|
Base Rate |
$1,930.97
|
Same |
|
FL
|
Base Rate |
$2,173.60
|
Same |
|
GA
|
Base Rate |
$2,173.60
|
Same |
|
HI
|
Base Rate |
$2,880.98
|
Same |
|
IA
|
Base Rate |
$1,920.69
|
Same |
|
ID
|
Base Rate |
$2,396.60
|
Same |
|
IL
|
Base Rate |
$2,363.43
|
Same |
|
IN
|
Base Rate |
$2,363.43
|
Same |
|
KS
|
Base Rate |
$1,920.69
|
Same |
|
KY
|
Base Rate |
$2,173.60
|
Same |
|
LA
|
Base Rate |
$1,797.45
|
Same |
|
MA
|
Base Rate |
$1,797.45
|
Same |
|
MD
|
Base Rate |
$1,930.97
|
Same |
|
ME
|
Base Rate |
$1,797.45
|
Same |
|
MI
|
Base Rate |
$2,363.43
|
Same |
|
MN
|
Base Rate |
$2,363.43
|
Same |
|
MO
|
Base Rate |
$1,920.69
|
Same |
|
MS
|
Base Rate |
$2,173.60
|
Same |
|
MT
|
Base Rate |
$1,797.45
|
Same |
|
NC
|
Base Rate |
$2,173.60
|
Same |
|
ND
|
Base Rate |
$1,797.45
|
Same |
|
NE
|
Base Rate |
$1,920.69
|
Same |
|
NH
|
Base Rate |
$1,797.45
|
Same |
|
NJ
|
Base Rate |
$2,147.09
|
Same |
|
NM
|
Base Rate |
$1,797.45
|
Same |
|
NV
|
Base Rate |
$2,396.60
|
Same |
|
NY
|
Base Rate |
$2,147.09
|
Same |
|
OH
|
Base Rate |
$2,363.43
|
Same |
|
OK
|
Base Rate |
$1,797.45
|
Same |
|
OR
|
Base Rate |
$2,396.60
|
Same |
|
PA
|
Base Rate |
$1,930.97
|
Same |
|
PR
|
Base Rate |
$2,147.01
|
Same |
|
RI
|
Base Rate |
$1,797.45
|
Same |
|
SC
|
Base Rate |
$2,173.60
|
Same |
|
SD
|
Base Rate |
$1,797.45
|
Same |
|
TN
|
Base Rate |
$2,173.60
|
Same |
|
TX
|
Base Rate |
$1,797.45
|
Same |
|
UT
|
Base Rate |
$1,797.45
|
Same |
|
VA
|
Base Rate |
$1,930.97
|
Same |
|
VI
|
Base Rate |
$2,147.08
|
Same |
|
VT
|
Base Rate |
$1,797.45
|
Same |
|
WA
|
Base Rate |
$2,396.60
|
Same |
|
WI
|
Base Rate |
$2,363.43
|
Same |
|
WV
|
Base Rate |
$1,930.97
|
Same |
|
WY
|
Base Rate |
$1,797.45
|
Same |