L6945
Prosthetics & Orthotics
53 States
Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
Short Desc
Elbow disart myoelectronic c
Coverage determined by local carrier discretion.
Added Date
1988-01-01
Effective From
1996-01-01
National Floor
$12,496.15
National Ceiling
$16,661.53
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$12,487.36
|
Same |
|
AL
|
Base Rate |
$13,124.47
|
Same |
|
AR
|
Base Rate |
$13,617.48
|
Same |
|
AZ
|
Base Rate |
$12,496.15
|
Same |
|
CA
|
Base Rate |
$12,496.15
|
Same |
|
CO
|
Base Rate |
$16,661.53
|
Same |
|
CT
|
Base Rate |
$13,225.96
|
Same |
|
DC
|
Base Rate |
$13,017.45
|
Same |
|
DE
|
Base Rate |
$13,017.45
|
Same |
|
FL
|
Base Rate |
$13,124.47
|
Same |
|
GA
|
Base Rate |
$13,124.47
|
Same |
|
HI
|
Base Rate |
$13,352.85
|
Same |
|
IA
|
Base Rate |
$12,496.15
|
Same |
|
ID
|
Base Rate |
$13,711.44
|
Same |
|
IL
|
Base Rate |
$14,312.50
|
Same |
|
IN
|
Base Rate |
$14,312.50
|
Same |
|
KS
|
Base Rate |
$12,496.15
|
Same |
|
KY
|
Base Rate |
$13,124.47
|
Same |
|
LA
|
Base Rate |
$13,617.48
|
Same |
|
MA
|
Base Rate |
$13,225.96
|
Same |
|
MD
|
Base Rate |
$13,017.45
|
Same |
|
ME
|
Base Rate |
$13,225.96
|
Same |
|
MI
|
Base Rate |
$14,312.50
|
Same |
|
MN
|
Base Rate |
$14,312.50
|
Same |
|
MO
|
Base Rate |
$12,496.15
|
Same |
|
MS
|
Base Rate |
$13,124.47
|
Same |
|
MT
|
Base Rate |
$16,661.53
|
Same |
|
NC
|
Base Rate |
$13,124.47
|
Same |
|
ND
|
Base Rate |
$16,661.53
|
Same |
|
NE
|
Base Rate |
$12,496.15
|
Same |
|
NH
|
Base Rate |
$13,225.96
|
Same |
|
NJ
|
Base Rate |
$12,767.03
|
Same |
|
NM
|
Base Rate |
$13,617.48
|
Same |
|
NV
|
Base Rate |
$12,496.15
|
Same |
|
NY
|
Base Rate |
$12,767.03
|
Same |
|
OH
|
Base Rate |
$14,312.50
|
Same |
|
OK
|
Base Rate |
$13,617.48
|
Same |
|
OR
|
Base Rate |
$13,711.44
|
Same |
|
PA
|
Base Rate |
$13,017.45
|
Same |
|
PR
|
Base Rate |
$17,607.82
|
Same |
|
RI
|
Base Rate |
$13,225.96
|
Same |
|
SC
|
Base Rate |
$13,124.47
|
Same |
|
SD
|
Base Rate |
$16,661.53
|
Same |
|
TN
|
Base Rate |
$13,124.47
|
Same |
|
TX
|
Base Rate |
$13,617.48
|
Same |
|
UT
|
Base Rate |
$16,661.53
|
Same |
|
VA
|
Base Rate |
$13,017.45
|
Same |
|
VI
|
Base Rate |
$12,767.03
|
Same |
|
VT
|
Base Rate |
$13,225.96
|
Same |
|
WA
|
Base Rate |
$13,711.44
|
Same |
|
WI
|
Base Rate |
$14,312.50
|
Same |
|
WV
|
Base Rate |
$13,017.45
|
Same |
|
WY
|
Base Rate |
$16,661.53
|
Same |