🔧 TEST VERSION • This is a preview of upcoming features
V2306 Prosthetics & Orthotics 53 States

Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens

Short Desc Lens sphcyl trifocal 4.00/>6
Coverage determined by local carrier discretion.
Added Date
1985-01-01
Effective From
2003-10-01
National Floor
$98.15
National Ceiling
$130.86

Fee Schedule Rates

Effective Jan 2026

Official Medicare DMEPOS pricing for 2026.

State Modifier Non-Rural Rural
AK
Base Rate
$102.94
Same
AL
Base Rate
$102.66
Same
AR
Base Rate
$130.86
Same
AZ
Base Rate
$100.34
Same
CA
Base Rate
$100.34
Same
CO
Base Rate
$113.55
Same
CT
Base Rate
$110.49
Same
DC
Base Rate
$127.70
Same
DE
Base Rate
$127.70
Same
FL
Base Rate
$102.66
Same
GA
Base Rate
$102.66
Same
HI
Base Rate
$110.08
Same
IA
Base Rate
$98.15
Same
ID
Base Rate
$98.15
Same
IL
Base Rate
$98.15
Same
IN
Base Rate
$98.15
Same
KS
Base Rate
$98.15
Same
KY
Base Rate
$102.66
Same
LA
Base Rate
$130.86
Same
MA
Base Rate
$110.49
Same
MD
Base Rate
$127.70
Same
ME
Base Rate
$110.49
Same
MI
Base Rate
$98.15
Same
MN
Base Rate
$98.15
Same
MO
Base Rate
$98.15
Same
MS
Base Rate
$102.66
Same
MT
Base Rate
$113.55
Same
NC
Base Rate
$102.66
Same
ND
Base Rate
$113.55
Same
NE
Base Rate
$98.15
Same
NH
Base Rate
$110.49
Same
NJ
Base Rate
$112.53
Same
NM
Base Rate
$130.86
Same
NV
Base Rate
$100.34
Same
NY
Base Rate
$112.53
Same
OH
Base Rate
$98.15
Same
OK
Base Rate
$130.86
Same
OR
Base Rate
$98.15
Same
PA
Base Rate
$127.70
Same
PR
Base Rate
$98.71
Same
RI
Base Rate
$110.49
Same
SC
Base Rate
$102.66
Same
SD
Base Rate
$113.55
Same
TN
Base Rate
$102.66
Same
TX
Base Rate
$130.86
Same
UT
Base Rate
$113.55
Same
VA
Base Rate
$127.70
Same
VI
Base Rate
$112.53
Same
VT
Base Rate
$110.49
Same
WA
Base Rate
$98.15
Same
WI
Base Rate
$98.15
Same
WV
Base Rate
$127.70
Same
WY
Base Rate
$113.55
Same