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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 L5940 D PO 500.60 667.46 n/a $534.10
2020 AL L5940 D PO 500.60 667.46 n/a $500.60
2020 AR L5940 D PO 500.60 667.46 n/a $667.46
2020 AZ L5940 D PO 500.60 667.46 n/a $532.05
2020 CA L5940 D PO 500.60 667.46 n/a $532.05
2020 CO L5940 D PO 500.60 667.46 n/a $667.46
2020 CT L5940 D PO 500.60 667.46 n/a $500.60
2020 DC L5940 D PO 500.60 667.46 n/a $500.60
2020 DE L5940 D PO 500.60 667.46 n/a $500.60
2020 FL L5940 D PO 500.60 667.46 n/a $500.60
2020 GA L5940 D PO 500.60 667.46 n/a $500.60
2020 HI L5940 D PO 500.60 667.46 n/a $571.09
2020 IA L5940 D PO 500.60 667.46 n/a $663.93
2020 ID L5940 D PO 500.60 667.46 n/a $622.40
2020 IL L5940 D PO 500.60 667.46 n/a $500.60
2020 IN L5940 D PO 500.60 667.46 n/a $500.60
2020 KS L5940 D PO 500.60 667.46 n/a $663.93
2020 KY L5940 D PO 500.60 667.46 n/a $500.60
2020 LA L5940 D PO 500.60 667.46 n/a $667.46
2020 MA L5940 D PO 500.60 667.46 n/a $500.60
2020 MD L5940 D PO 500.60 667.46 n/a $500.60
2020 ME L5940 D PO 500.60 667.46 n/a $500.60
2020 MI L5940 D PO 500.60 667.46 n/a $500.60
2020 MN L5940 D PO 500.60 667.46 n/a $500.60
2020 MO L5940 D PO 500.60 667.46 n/a $663.93
2020 MS L5940 D PO 500.60 667.46 n/a $500.60
2020 MT L5940 D PO 500.60 667.46 n/a $667.46
2020 NC L5940 D PO 500.60 667.46 n/a $500.60
2020 ND L5940 D PO 500.60 667.46 n/a $667.46
2020 NE L5940 D PO 500.60 667.46 n/a $663.93
2020 NH L5940 D PO 500.60 667.46 n/a $500.60
2020 NJ L5940 D PO 500.60 667.46 n/a $543.82
2020 NM L5940 D PO 500.60 667.46 n/a $667.46
2020 NV L5940 D PO 500.60 667.46 n/a $532.05
2020 NY L5940 D PO 500.60 667.46 n/a $543.82
2020 OH L5940 D PO 500.60 667.46 n/a $500.60
2020 OK L5940 D PO 500.60 667.46 n/a $667.46
2020 OR L5940 D PO 500.60 667.46 n/a $622.40
2020 PA L5940 D PO 500.60 667.46 n/a $500.60
2020 PR L5940 D PO 500.60 667.46 n/a $931.05
2020 RI L5940 D PO 500.60 667.46 n/a $500.60
2020 SC L5940 D PO 500.60 667.46 n/a $500.60
2020 SD L5940 D PO 500.60 667.46 n/a $667.46
2020 TN L5940 D PO 500.60 667.46 n/a $500.60
2020 TX L5940 D PO 500.60 667.46 n/a $667.46
2020 UT L5940 D PO 500.60 667.46 n/a $667.46
2020 VA L5940 D PO 500.60 667.46 n/a $500.60
2020 VI L5940 D PO 500.60 667.46 n/a $543.82
2020 VT L5940 D PO 500.60 667.46 n/a $500.60
2020 WA L5940 D PO 500.60 667.46 n/a $622.40
2020 WI L5940 D PO 500.60 667.46 n/a $500.60
2020 WV L5940 D PO 500.60 667.46 n/a $500.60
2020 WY L5940 D PO 500.60 667.46 n/a $667.46
Prosthetics / Orthotics, and Supplies
Year State Code Modifier 2nd Modifier Jurisdiction Category Floor Ceiling Rural Fee Non-rural Fee
2019 AK L5940 D PO 496.13 661.51 n/a $529.34
2019 AL L5940 D PO 496.13 661.51 n/a $496.13
2019 AR L5940 D PO 496.13 661.51 n/a $661.51
2019 AZ L5940 D PO 496.13 661.51 n/a $527.30
2019 CA L5940 D PO 496.13 661.51 n/a $527.30
2019 CO L5940 D PO 496.13 661.51 n/a $661.51
2019 CT L5940 D PO 496.13 661.51 n/a $496.13
2019 DC L5940 D PO 496.13 661.51 n/a $496.13
2019 DE L5940 D PO 496.13 661.51 n/a $496.13
2019 FL L5940 D PO 496.13 661.51 n/a $496.13
2019 GA L5940 D PO 496.13 661.51 n/a $496.13
2019 HI L5940 D PO 496.13 661.51 n/a $566.00
2019 IA L5940 D PO 496.13 661.51 n/a $658.01
2019 ID L5940 D PO 496.13 661.51 n/a $616.85
2019 IL L5940 D PO 496.13 661.51 n/a $496.13
2019 IN L5940 D PO 496.13 661.51 n/a $496.13
2019 KS L5940 D PO 496.13 661.51 n/a $658.01
2019 KY L5940 D PO 496.13 661.51 n/a $496.13
2019 LA L5940 D PO 496.13 661.51 n/a $661.51
2019 MA L5940 D PO 496.13 661.51 n/a $496.13
2019 MD L5940 D PO 496.13 661.51 n/a $496.13
2019 ME L5940 D PO 496.13 661.51 n/a $496.13
2019 MI L5940 D PO 496.13 661.51 n/a $496.13
2019 MN L5940 D PO 496.13 661.51 n/a $496.13
2019 MO L5940 D PO 496.13 661.51 n/a $658.01
2019 MS L5940 D PO 496.13 661.51 n/a $496.13
2019 MT L5940 D PO 496.13 661.51 n/a $661.51
2019 NC L5940 D PO 496.13 661.51 n/a $496.13
2019 ND L5940 D PO 496.13 661.51 n/a $661.51
2019 NE L5940 D PO 496.13 661.51 n/a $658.01
2019 NH L5940 D PO 496.13 661.51 n/a $496.13
2019 NJ L5940 D PO 496.13 661.51 n/a $538.97
2019 NM L5940 D PO 496.13 661.51 n/a $661.51
2019 NV L5940 D PO 496.13 661.51 n/a $527.30
2019 NY L5940 D PO 496.13 661.51 n/a $538.97
2019 OH L5940 D PO 496.13 661.51 n/a $496.13
2019 OK L5940 D PO 496.13 661.51 n/a $661.51
2019 OR L5940 D PO 496.13 661.51 n/a $616.85
2019 PA L5940 D PO 496.13 661.51 n/a $496.13
2019 PR L5940 D PO 496.13 661.51 n/a $922.75
2019 RI L5940 D PO 496.13 661.51 n/a $496.13
2019 SC L5940 D PO 496.13 661.51 n/a $496.13
2019 SD L5940 D PO 496.13 661.51 n/a $661.51
2019 TN L5940 D PO 496.13 661.51 n/a $496.13
2019 TX L5940 D PO 496.13 661.51 n/a $661.51
2019 UT L5940 D PO 496.13 661.51 n/a $661.51
2019 VA L5940 D PO 496.13 661.51 n/a $496.13
2019 VI L5940 D PO 496.13 661.51 n/a $538.97
2019 VT L5940 D PO 496.13 661.51 n/a $496.13
2019 WA L5940 D PO 496.13 661.51 n/a $616.85
2019 WI L5940 D PO 496.13 661.51 n/a $496.13
2019 WV L5940 D PO 496.13 661.51 n/a $496.13
2019 WY L5940 D PO 496.13 661.51 n/a $661.51

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