L6930
Prosthetics & Orthotics
53 States
Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
Short Desc
Below elbow switch control
Coverage determined by local carrier discretion.
Added Date
1988-01-01
Effective From
1996-01-01
National Floor
$8,220.96
National Ceiling
$10,961.27
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$8,542.82
|
Same |
|
AL
|
Base Rate |
$8,220.96
|
Same |
|
AR
|
Base Rate |
$9,631.82
|
Same |
|
AZ
|
Base Rate |
$8,495.44
|
Same |
|
CA
|
Base Rate |
$8,495.44
|
Same |
|
CO
|
Base Rate |
$10,435.11
|
Same |
|
CT
|
Base Rate |
$9,103.80
|
Same |
|
DC
|
Base Rate |
$8,927.42
|
Same |
|
DE
|
Base Rate |
$8,927.42
|
Same |
|
FL
|
Base Rate |
$8,220.96
|
Same |
|
GA
|
Base Rate |
$8,220.96
|
Same |
|
HI
|
Base Rate |
$9,134.88
|
Same |
|
IA
|
Base Rate |
$9,119.06
|
Same |
|
ID
|
Base Rate |
$10,335.88
|
Same |
|
IL
|
Base Rate |
$9,934.80
|
Same |
|
IN
|
Base Rate |
$9,934.80
|
Same |
|
KS
|
Base Rate |
$9,119.06
|
Same |
|
KY
|
Base Rate |
$8,220.96
|
Same |
|
LA
|
Base Rate |
$9,631.82
|
Same |
|
MA
|
Base Rate |
$9,103.80
|
Same |
|
MD
|
Base Rate |
$8,927.42
|
Same |
|
ME
|
Base Rate |
$9,103.80
|
Same |
|
MI
|
Base Rate |
$9,934.80
|
Same |
|
MN
|
Base Rate |
$9,934.80
|
Same |
|
MO
|
Base Rate |
$9,119.06
|
Same |
|
MS
|
Base Rate |
$8,220.96
|
Same |
|
MT
|
Base Rate |
$10,435.11
|
Same |
|
NC
|
Base Rate |
$8,220.96
|
Same |
|
ND
|
Base Rate |
$10,435.11
|
Same |
|
NE
|
Base Rate |
$9,119.06
|
Same |
|
NH
|
Base Rate |
$9,103.80
|
Same |
|
NJ
|
Base Rate |
$8,220.96
|
Same |
|
NM
|
Base Rate |
$9,631.82
|
Same |
|
NV
|
Base Rate |
$8,495.44
|
Same |
|
NY
|
Base Rate |
$8,220.96
|
Same |
|
OH
|
Base Rate |
$9,934.80
|
Same |
|
OK
|
Base Rate |
$9,631.82
|
Same |
|
OR
|
Base Rate |
$10,335.88
|
Same |
|
PA
|
Base Rate |
$8,927.42
|
Same |
|
PR
|
Base Rate |
$6,795.44
|
Same |
|
RI
|
Base Rate |
$9,103.80
|
Same |
|
SC
|
Base Rate |
$8,220.96
|
Same |
|
SD
|
Base Rate |
$10,435.11
|
Same |
|
TN
|
Base Rate |
$8,220.96
|
Same |
|
TX
|
Base Rate |
$9,631.82
|
Same |
|
UT
|
Base Rate |
$10,435.11
|
Same |
|
VA
|
Base Rate |
$8,927.42
|
Same |
|
VI
|
Base Rate |
$8,220.96
|
Same |
|
VT
|
Base Rate |
$9,103.80
|
Same |
|
WA
|
Base Rate |
$10,335.88
|
Same |
|
WI
|
Base Rate |
$9,934.80
|
Same |
|
WV
|
Base Rate |
$8,927.42
|
Same |
|
WY
|
Base Rate |
$10,435.11
|
Same |