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The DMEPOS fee schedule contains fee schedule amounts for each procedure code subject to fee schedule payment methodologies. Beginning January 1, 2016, the data will also contain fee schedule amounts for certain procedure codes that have been adjusted using information from the competitive bidding programs. Note: Fee schedule amounts for those codes not adjusted using competitive bidding information will only have fee schedule amounts in the non-rural columns.

See also Ambulance Fee Schedule · Carrier Locality Codes

Prosthetics / Orthotics, and Supplies
Year State Code Modifier 2nd Modifier Jurisdiction Category Floor Ceiling Rural Fee Non-rural Fee
2020 AK L2755 D PO 116.93 155.91 n/a $129.04
2020 AL L2755 D PO 116.93 155.91 n/a $131.64
2020 AR L2755 D PO 116.93 155.91 n/a $131.63
2020 AZ L2755 D PO 116.93 155.91 n/a $127.78
2020 CA L2755 D PO 116.93 155.91 n/a $127.78
2020 CO L2755 D PO 116.93 155.91 n/a $132.30
2020 CT L2755 D PO 116.93 155.91 n/a $127.72
2020 DC L2755 D PO 116.93 155.91 n/a $127.74
2020 DE L2755 D PO 116.93 155.91 n/a $127.74
2020 FL L2755 D PO 116.93 155.91 n/a $131.64
2020 GA L2755 D PO 116.93 155.91 n/a $131.64
2020 HI L2755 D PO 116.93 155.91 n/a $138.03
2020 IA L2755 D PO 116.93 155.91 n/a $130.25
2020 ID L2755 D PO 116.93 155.91 n/a $127.78
2020 IL L2755 D PO 116.93 155.91 n/a $130.90
2020 IN L2755 D PO 116.93 155.91 n/a $130.90
2020 KS L2755 D PO 116.93 155.91 n/a $130.25
2020 KY L2755 D PO 116.93 155.91 n/a $131.64
2020 LA L2755 D PO 116.93 155.91 n/a $131.63
2020 MA L2755 D PO 116.93 155.91 n/a $127.72
2020 MD L2755 D PO 116.93 155.91 n/a $127.74
2020 ME L2755 D PO 116.93 155.91 n/a $127.72
2020 MI L2755 D PO 116.93 155.91 n/a $130.90
2020 MN L2755 D PO 116.93 155.91 n/a $130.90
2020 MO L2755 D PO 116.93 155.91 n/a $130.25
2020 MS L2755 D PO 116.93 155.91 n/a $131.64
2020 MT L2755 D PO 116.93 155.91 n/a $132.30
2020 NC L2755 D PO 116.93 155.91 n/a $131.64
2020 ND L2755 D PO 116.93 155.91 n/a $132.30
2020 NE L2755 D PO 116.93 155.91 n/a $130.25
2020 NH L2755 D PO 116.93 155.91 n/a $127.72
2020 NJ L2755 D PO 116.93 155.91 n/a $127.72
2020 NM L2755 D PO 116.93 155.91 n/a $131.63
2020 NV L2755 D PO 116.93 155.91 n/a $127.78
2020 NY L2755 D PO 116.93 155.91 n/a $127.72
2020 OH L2755 D PO 116.93 155.91 n/a $130.90
2020 OK L2755 D PO 116.93 155.91 n/a $131.63
2020 OR L2755 D PO 116.93 155.91 n/a $127.78
2020 PA L2755 D PO 116.93 155.91 n/a $127.74
2020 PR L2755 D PO 116.93 155.91 n/a $140.56
2020 RI L2755 D PO 116.93 155.91 n/a $127.72
2020 SC L2755 D PO 116.93 155.91 n/a $131.64
2020 SD L2755 D PO 116.93 155.91 n/a $132.30
2020 TN L2755 D PO 116.93 155.91 n/a $131.64
2020 TX L2755 D PO 116.93 155.91 n/a $131.63
2020 UT L2755 D PO 116.93 155.91 n/a $132.30
2020 VA L2755 D PO 116.93 155.91 n/a $127.74
2020 VI L2755 D PO 116.93 155.91 n/a $140.56
2020 VT L2755 D PO 116.93 155.91 n/a $127.72
2020 WA L2755 D PO 116.93 155.91 n/a $127.78
2020 WI L2755 D PO 116.93 155.91 n/a $130.90
2020 WV L2755 D PO 116.93 155.91 n/a $127.74
2020 WY L2755 D PO 116.93 155.91 n/a $132.30
Prosthetics / Orthotics, and Supplies
Year State Code Modifier 2nd Modifier Jurisdiction Category Floor Ceiling Rural Fee Non-rural Fee
2019 AK L2755 D PO 115.89 154.52 n/a $127.89
2019 AL L2755 D PO 115.89 154.52 n/a $130.47
2019 AR L2755 D PO 115.89 154.52 n/a $130.46
2019 AZ L2755 D PO 115.89 154.52 n/a $126.64
2019 CA L2755 D PO 115.89 154.52 n/a $126.64
2019 CO L2755 D PO 115.89 154.52 n/a $131.12
2019 CT L2755 D PO 115.89 154.52 n/a $126.58
2019 DC L2755 D PO 115.89 154.52 n/a $126.60
2019 DE L2755 D PO 115.89 154.52 n/a $126.60
2019 FL L2755 D PO 115.89 154.52 n/a $130.47
2019 GA L2755 D PO 115.89 154.52 n/a $130.47
2019 HI L2755 D PO 115.89 154.52 n/a $136.80
2019 IA L2755 D PO 115.89 154.52 n/a $129.09
2019 ID L2755 D PO 115.89 154.52 n/a $126.64
2019 IL L2755 D PO 115.89 154.52 n/a $129.73
2019 IN L2755 D PO 115.89 154.52 n/a $129.73
2019 KS L2755 D PO 115.89 154.52 n/a $129.09
2019 KY L2755 D PO 115.89 154.52 n/a $130.47
2019 LA L2755 D PO 115.89 154.52 n/a $130.46
2019 MA L2755 D PO 115.89 154.52 n/a $126.58
2019 MD L2755 D PO 115.89 154.52 n/a $126.60
2019 ME L2755 D PO 115.89 154.52 n/a $126.58
2019 MI L2755 D PO 115.89 154.52 n/a $129.73
2019 MN L2755 D PO 115.89 154.52 n/a $129.73
2019 MO L2755 D PO 115.89 154.52 n/a $129.09
2019 MS L2755 D PO 115.89 154.52 n/a $130.47
2019 MT L2755 D PO 115.89 154.52 n/a $131.12
2019 NC L2755 D PO 115.89 154.52 n/a $130.47
2019 ND L2755 D PO 115.89 154.52 n/a $131.12
2019 NE L2755 D PO 115.89 154.52 n/a $129.09
2019 NH L2755 D PO 115.89 154.52 n/a $126.58
2019 NJ L2755 D PO 115.89 154.52 n/a $126.58
2019 NM L2755 D PO 115.89 154.52 n/a $130.46
2019 NV L2755 D PO 115.89 154.52 n/a $126.64
2019 NY L2755 D PO 115.89 154.52 n/a $126.58
2019 OH L2755 D PO 115.89 154.52 n/a $129.73
2019 OK L2755 D PO 115.89 154.52 n/a $130.46
2019 OR L2755 D PO 115.89 154.52 n/a $126.64
2019 PA L2755 D PO 115.89 154.52 n/a $126.60
2019 PR L2755 D PO 115.89 154.52 n/a $139.31
2019 RI L2755 D PO 115.89 154.52 n/a $126.58
2019 SC L2755 D PO 115.89 154.52 n/a $130.47
2019 SD L2755 D PO 115.89 154.52 n/a $131.12
2019 TN L2755 D PO 115.89 154.52 n/a $130.47
2019 TX L2755 D PO 115.89 154.52 n/a $130.46
2019 UT L2755 D PO 115.89 154.52 n/a $131.12
2019 VA L2755 D PO 115.89 154.52 n/a $126.60
2019 VI L2755 D PO 115.89 154.52 n/a $139.31
2019 VT L2755 D PO 115.89 154.52 n/a $126.58
2019 WA L2755 D PO 115.89 154.52 n/a $126.64
2019 WI L2755 D PO 115.89 154.52 n/a $129.73
2019 WV L2755 D PO 115.89 154.52 n/a $126.60
2019 WY L2755 D PO 115.89 154.52 n/a $131.12

Rural vs Non-rural Fees

Beginning January 1, 2016, some codes have rural and non-rural adjusted fee schedule amounts based on information from competitive bidding programs. Where applicable, the service location will determine the fee schedule to use for codes that contains both rural and non-rural fees. Otherwise, only the non-rural fee schedule should be used.

Click the Rural Fee to check if the service location is considered rural.


Jurisdiction

  • C - Local Part B Carrier
  • D - DMEMAC
  • J - Joint DMEMAC / Local Carrier

Category

  • CR - Capped Rental Items
  • FS - Frequently Serviced Items
  • IL - Intraocular Lenses
  • IN - Inexpensive and Other Routinely Purchased Items
  • OS - Ostomy, Tracheostomy & Urological Items
  • OX - Oxygen and Oxygen Equipment
  • PE - Parenteral and Enteral Nutrition
  • PO - Prosthetics & Orthotics
  • SC - Splints and Casts
  • SD - Surgical Dressings
  • SU - Supplies
  • TE - Transcutaneous Electrical Nerve Stimulators
  • TS - Therapeutic Shoes