🔧 TEST VERSION • This is a preview of upcoming features
V2312 Prosthetics & Orthotics 53 States

Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens

Short Desc Lens sphc trifo 7.25-12/2.25
Coverage determined by local carrier discretion.
Added Date
1985-01-01
Effective From
2003-10-01
National Floor
$109.70
National Ceiling
$146.27

Fee Schedule Rates

Effective Jan 2026

Official Medicare DMEPOS pricing for 2026.

State Modifier Non-Rural Rural
AK
Base Rate
$182.02
Same
AL
Base Rate
$117.34
Same
AR
Base Rate
$123.93
Same
AZ
Base Rate
$146.27
Same
CA
Base Rate
$146.27
Same
CO
Base Rate
$109.70
Same
CT
Base Rate
$146.27
Same
DC
Base Rate
$123.41
Same
DE
Base Rate
$123.41
Same
FL
Base Rate
$117.34
Same
GA
Base Rate
$117.34
Same
HI
Base Rate
$194.59
Same
IA
Base Rate
$109.70
Same
ID
Base Rate
$112.33
Same
IL
Base Rate
$117.92
Same
IN
Base Rate
$117.92
Same
KS
Base Rate
$109.70
Same
KY
Base Rate
$117.34
Same
LA
Base Rate
$123.93
Same
MA
Base Rate
$146.27
Same
MD
Base Rate
$123.41
Same
ME
Base Rate
$146.27
Same
MI
Base Rate
$117.92
Same
MN
Base Rate
$117.92
Same
MO
Base Rate
$109.70
Same
MS
Base Rate
$117.34
Same
MT
Base Rate
$109.70
Same
NC
Base Rate
$117.34
Same
ND
Base Rate
$109.70
Same
NE
Base Rate
$109.70
Same
NH
Base Rate
$146.27
Same
NJ
Base Rate
$110.18
Same
NM
Base Rate
$123.93
Same
NV
Base Rate
$146.27
Same
NY
Base Rate
$110.18
Same
OH
Base Rate
$117.92
Same
OK
Base Rate
$123.93
Same
OR
Base Rate
$112.33
Same
PA
Base Rate
$123.41
Same
PR
Base Rate
$118.08
Same
RI
Base Rate
$146.27
Same
SC
Base Rate
$117.34
Same
SD
Base Rate
$109.70
Same
TN
Base Rate
$117.34
Same
TX
Base Rate
$123.93
Same
UT
Base Rate
$109.70
Same
VA
Base Rate
$123.41
Same
VI
Base Rate
$110.18
Same
VT
Base Rate
$146.27
Same
WA
Base Rate
$112.33
Same
WI
Base Rate
$117.92
Same
WV
Base Rate
$123.41
Same
WY
Base Rate
$109.70
Same