L8041
Prosthetics & Orthotics
159 States
Midfacial prosthesis, provided by a non-physician
Short Desc
Midfacial prosthesis
Coverage determined by local carrier discretion.
Added Date
2001-01-01
Effective From
2001-01-01
National Floor
$3,283.88
National Ceiling
$4,378.51
Fee Schedule Rates
Effective Jan 2026Official Medicare DMEPOS pricing for 2026.
| State | Modifier | Non-Rural | Rural |
|---|---|---|---|
|
AK
|
Base Rate |
$4,066.42
|
Same |
|
AK
|
KM |
$3,863.11
|
Same |
|
AK
|
KN |
$1,626.57
|
Same |
|
AL
|
Base Rate |
$3,606.94
|
Same |
|
AL
|
KM |
$3,426.59
|
Same |
|
AL
|
KN |
$1,442.78
|
Same |
|
AR
|
Base Rate |
$3,556.45
|
Same |
|
AR
|
KM |
$3,378.62
|
Same |
|
AR
|
KN |
$1,422.56
|
Same |
|
AZ
|
Base Rate |
$3,794.81
|
Same |
|
AZ
|
KM |
$3,605.07
|
Same |
|
AZ
|
KN |
$1,517.97
|
Same |
|
CA
|
Base Rate |
$3,794.81
|
Same |
|
CA
|
KM |
$3,605.07
|
Same |
|
CA
|
KN |
$1,517.97
|
Same |
|
CO
|
Base Rate |
$3,465.95
|
Same |
|
CO
|
KM |
$3,292.65
|
Same |
|
CO
|
KN |
$1,386.36
|
Same |
|
CT
|
Base Rate |
$3,877.12
|
Same |
|
CT
|
KM |
$3,683.28
|
Same |
|
CT
|
KN |
$1,550.86
|
Same |
|
DC
|
Base Rate |
$3,692.26
|
Same |
|
DC
|
KM |
$3,507.63
|
Same |
|
DC
|
KN |
$1,476.93
|
Same |
|
DE
|
Base Rate |
$3,692.26
|
Same |
|
DE
|
KM |
$3,507.63
|
Same |
|
DE
|
KN |
$1,476.93
|
Same |
|
FL
|
Base Rate |
$3,606.94
|
Same |
|
FL
|
KM |
$3,426.59
|
Same |
|
FL
|
KN |
$1,442.78
|
Same |
|
GA
|
Base Rate |
$3,606.94
|
Same |
|
GA
|
KM |
$3,426.59
|
Same |
|
GA
|
KN |
$1,442.78
|
Same |
|
HI
|
Base Rate |
$3,893.35
|
Same |
|
HI
|
KM |
$3,698.63
|
Same |
|
HI
|
KN |
$1,557.32
|
Same |
|
IA
|
Base Rate |
$3,390.11
|
Same |
|
IA
|
KM |
$3,220.58
|
Same |
|
IA
|
KN |
$1,356.04
|
Same |
|
ID
|
Base Rate |
$3,622.02
|
Same |
|
ID
|
KM |
$3,440.86
|
Same |
|
ID
|
KN |
$1,448.81
|
Same |
|
IL
|
Base Rate |
$3,679.20
|
Same |
|
IL
|
KM |
$3,495.19
|
Same |
|
IL
|
KN |
$1,471.71
|
Same |
|
IN
|
Base Rate |
$3,679.20
|
Same |
|
IN
|
KM |
$3,495.19
|
Same |
|
IN
|
KN |
$1,471.71
|
Same |
|
KS
|
Base Rate |
$3,390.11
|
Same |
|
KS
|
KM |
$3,220.58
|
Same |
|
KS
|
KN |
$1,356.04
|
Same |
|
KY
|
Base Rate |
$3,606.94
|
Same |
|
KY
|
KM |
$3,426.59
|
Same |
|
KY
|
KN |
$1,442.78
|
Same |
|
LA
|
Base Rate |
$3,556.45
|
Same |
|
LA
|
KM |
$3,378.62
|
Same |
|
LA
|
KN |
$1,422.56
|
Same |
|
MA
|
Base Rate |
$3,877.12
|
Same |
|
MA
|
KM |
$3,683.28
|
Same |
|
MA
|
KN |
$1,550.86
|
Same |
|
MD
|
Base Rate |
$3,692.26
|
Same |
|
MD
|
KM |
$3,507.63
|
Same |
|
MD
|
KN |
$1,476.93
|
Same |
|
ME
|
Base Rate |
$3,877.12
|
Same |
|
ME
|
KM |
$3,683.28
|
Same |
|
ME
|
KN |
$1,550.86
|
Same |
|
MI
|
Base Rate |
$3,679.20
|
Same |
|
MI
|
KM |
$3,495.19
|
Same |
|
MI
|
KN |
$1,471.71
|
Same |
|
MN
|
Base Rate |
$3,679.20
|
Same |
|
MN
|
KM |
$3,495.19
|
Same |
|
MN
|
KN |
$1,471.71
|
Same |
|
MO
|
Base Rate |
$3,390.11
|
Same |
|
MO
|
KM |
$3,220.58
|
Same |
|
MO
|
KN |
$1,356.04
|
Same |
|
MS
|
Base Rate |
$3,606.94
|
Same |
|
MS
|
KM |
$3,426.59
|
Same |
|
MS
|
KN |
$1,442.78
|
Same |
|
MT
|
Base Rate |
$3,465.95
|
Same |
|
MT
|
KM |
$3,292.65
|
Same |
|
MT
|
KN |
$1,386.36
|
Same |
|
NC
|
Base Rate |
$3,606.94
|
Same |
|
NC
|
KM |
$3,426.59
|
Same |
|
NC
|
KN |
$1,442.78
|
Same |
|
ND
|
Base Rate |
$3,465.95
|
Same |
|
ND
|
KM |
$3,292.65
|
Same |
|
ND
|
KN |
$1,386.36
|
Same |
|
NE
|
Base Rate |
$3,390.11
|
Same |
|
NE
|
KM |
$3,220.58
|
Same |
|
NE
|
KN |
$1,356.04
|
Same |
|
NH
|
Base Rate |
$3,877.12
|
Same |
|
NH
|
KM |
$3,683.28
|
Same |
|
NH
|
KN |
$1,550.86
|
Same |
|
NJ
|
Base Rate |
$4,026.69
|
Same |
|
NJ
|
KM |
$3,825.34
|
Same |
|
NJ
|
KN |
$1,610.68
|
Same |
|
NM
|
Base Rate |
$3,556.45
|
Same |
|
NM
|
KM |
$3,378.62
|
Same |
|
NM
|
KN |
$1,422.56
|
Same |
|
NV
|
Base Rate |
$3,794.81
|
Same |
|
NV
|
KM |
$3,605.07
|
Same |
|
NV
|
KN |
$1,517.97
|
Same |
|
NY
|
Base Rate |
$4,026.69
|
Same |
|
NY
|
KM |
$3,825.34
|
Same |
|
NY
|
KN |
$1,610.68
|
Same |
|
OH
|
Base Rate |
$3,679.20
|
Same |
|
OH
|
KM |
$3,495.19
|
Same |
|
OH
|
KN |
$1,471.71
|
Same |
|
OK
|
Base Rate |
$3,556.45
|
Same |
|
OK
|
KM |
$3,378.62
|
Same |
|
OK
|
KN |
$1,422.56
|
Same |
|
OR
|
Base Rate |
$3,622.02
|
Same |
|
OR
|
KM |
$3,440.86
|
Same |
|
OR
|
KN |
$1,448.81
|
Same |
|
PA
|
Base Rate |
$3,692.26
|
Same |
|
PA
|
KM |
$3,507.63
|
Same |
|
PA
|
KN |
$1,476.93
|
Same |
|
PR
|
Base Rate |
$3,413.33
|
Same |
|
PR
|
KM |
$3,242.65
|
Same |
|
PR
|
KN |
$1,365.32
|
Same |
|
RI
|
Base Rate |
$3,877.12
|
Same |
|
RI
|
KM |
$3,683.28
|
Same |
|
RI
|
KN |
$1,550.86
|
Same |
|
SC
|
Base Rate |
$3,606.94
|
Same |
|
SC
|
KM |
$3,426.59
|
Same |
|
SC
|
KN |
$1,442.78
|
Same |
|
SD
|
Base Rate |
$3,465.95
|
Same |
|
SD
|
KM |
$3,292.65
|
Same |
|
SD
|
KN |
$1,386.36
|
Same |
|
TN
|
Base Rate |
$3,606.94
|
Same |
|
TN
|
KM |
$3,426.59
|
Same |
|
TN
|
KN |
$1,442.78
|
Same |
|
TX
|
Base Rate |
$3,556.45
|
Same |
|
TX
|
KM |
$3,378.62
|
Same |
|
TX
|
KN |
$1,422.56
|
Same |
|
UT
|
Base Rate |
$3,465.95
|
Same |
|
UT
|
KM |
$3,292.65
|
Same |
|
UT
|
KN |
$1,386.36
|
Same |
|
VA
|
Base Rate |
$3,692.26
|
Same |
|
VA
|
KM |
$3,507.63
|
Same |
|
VA
|
KN |
$1,476.93
|
Same |
|
VI
|
Base Rate |
$4,311.87
|
Same |
|
VI
|
KM |
$4,096.29
|
Same |
|
VI
|
KN |
$1,724.76
|
Same |
|
VT
|
Base Rate |
$3,877.12
|
Same |
|
VT
|
KM |
$3,683.28
|
Same |
|
VT
|
KN |
$1,550.86
|
Same |
|
WA
|
Base Rate |
$3,622.02
|
Same |
|
WA
|
KM |
$3,440.86
|
Same |
|
WA
|
KN |
$1,448.81
|
Same |
|
WI
|
Base Rate |
$3,679.20
|
Same |
|
WI
|
KM |
$3,495.19
|
Same |
|
WI
|
KN |
$1,471.71
|
Same |
|
WV
|
Base Rate |
$3,692.26
|
Same |
|
WV
|
KM |
$3,507.63
|
Same |
|
WV
|
KN |
$1,476.93
|
Same |
|
WY
|
Base Rate |
$3,465.95
|
Same |
|
WY
|
KM |
$3,292.65
|
Same |
|
WY
|
KN |
$1,386.36
|
Same |