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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
2019 AK L5960 D PO 953.51 1271.34 n/a $916.89
2019 AL L5960 D PO 953.51 1271.34 n/a $953.51
2019 AR L5960 D PO 953.51 1271.34 n/a $1271.34
2019 AZ L5960 D PO 953.51 1271.34 n/a $953.51
2019 CA L5960 D PO 953.51 1271.34 n/a $953.51
2019 CO L5960 D PO 953.51 1271.34 n/a $953.51
2019 CT L5960 D PO 953.51 1271.34 n/a $1062.77
2019 DC L5960 D PO 953.51 1271.34 n/a $1003.95
2019 DE L5960 D PO 953.51 1271.34 n/a $1003.95
2019 FL L5960 D PO 953.51 1271.34 n/a $953.51
2019 GA L5960 D PO 953.51 1271.34 n/a $953.51
2019 HI L5960 D PO 953.51 1271.34 n/a $980.50
2019 IA L5960 D PO 953.51 1271.34 n/a $1057.30
2019 ID L5960 D PO 953.51 1271.34 n/a $1013.39
2019 IL L5960 D PO 953.51 1271.34 n/a $1150.61
2019 IN L5960 D PO 953.51 1271.34 n/a $1150.61
2019 KS L5960 D PO 953.51 1271.34 n/a $1057.30
2019 KY L5960 D PO 953.51 1271.34 n/a $953.51
2019 LA L5960 D PO 953.51 1271.34 n/a $1271.34
2019 MA L5960 D PO 953.51 1271.34 n/a $1062.77
2019 MD L5960 D PO 953.51 1271.34 n/a $1003.95
2019 ME L5960 D PO 953.51 1271.34 n/a $1062.77
2019 MI L5960 D PO 953.51 1271.34 n/a $1150.61
2019 MN L5960 D PO 953.51 1271.34 n/a $1150.61
2019 MO L5960 D PO 953.51 1271.34 n/a $1057.30
2019 MS L5960 D PO 953.51 1271.34 n/a $953.51
2019 MT L5960 D PO 953.51 1271.34 n/a $953.51
2019 NC L5960 D PO 953.51 1271.34 n/a $953.51
2019 ND L5960 D PO 953.51 1271.34 n/a $953.51
2019 NE L5960 D PO 953.51 1271.34 n/a $1057.30
2019 NH L5960 D PO 953.51 1271.34 n/a $1062.77
2019 NJ L5960 D PO 953.51 1271.34 n/a $1265.78
2019 NM L5960 D PO 953.51 1271.34 n/a $1271.34
2019 NV L5960 D PO 953.51 1271.34 n/a $953.51
2019 NY L5960 D PO 953.51 1271.34 n/a $1265.78
2019 OH L5960 D PO 953.51 1271.34 n/a $1150.61
2019 OK L5960 D PO 953.51 1271.34 n/a $1271.34
2019 OR L5960 D PO 953.51 1271.34 n/a $1013.39
2019 PA L5960 D PO 953.51 1271.34 n/a $1003.95
2019 PR L5960 D PO 953.51 1271.34 n/a $1883.93
2019 RI L5960 D PO 953.51 1271.34 n/a $1062.77
2019 SC L5960 D PO 953.51 1271.34 n/a $953.51
2019 SD L5960 D PO 953.51 1271.34 n/a $953.51
2019 TN L5960 D PO 953.51 1271.34 n/a $953.51
2019 TX L5960 D PO 953.51 1271.34 n/a $1271.34
2019 UT L5960 D PO 953.51 1271.34 n/a $953.51
2019 VA L5960 D PO 953.51 1271.34 n/a $1003.95
2019 VI L5960 D PO 953.51 1271.34 n/a $1265.77
2019 VT L5960 D PO 953.51 1271.34 n/a $1062.77
2019 WA L5960 D PO 953.51 1271.34 n/a $1013.39
2019 WI L5960 D PO 953.51 1271.34 n/a $1150.61
2019 WV L5960 D PO 953.51 1271.34 n/a $1003.95
2019 WY L5960 D PO 953.51 1271.34 n/a $953.51
Prosthetics / Orthotics, and Supplies
Year State Code Modifier 2nd Modifier Jurisdiction Category Floor Ceiling Rural Fee Non-rural Fee
2018 AK L5960 D PO 932.07 1242.76 n/a $896.28
2018 AL L5960 D PO 932.07 1242.76 n/a $932.07
2018 AR L5960 D PO 932.07 1242.76 n/a $1242.76
2018 AZ L5960 D PO 932.07 1242.76 n/a $932.07
2018 CA L5960 D PO 932.07 1242.76 n/a $932.07
2018 CO L5960 D PO 932.07 1242.76 n/a $932.07
2018 CT L5960 D PO 932.07 1242.76 n/a $1038.88
2018 DC L5960 D PO 932.07 1242.76 n/a $981.38
2018 DE L5960 D PO 932.07 1242.76 n/a $981.38
2018 FL L5960 D PO 932.07 1242.76 n/a $932.07
2018 GA L5960 D PO 932.07 1242.76 n/a $932.07
2018 HI L5960 D PO 932.07 1242.76 n/a $958.46
2018 IA L5960 D PO 932.07 1242.76 n/a $1033.53
2018 ID L5960 D PO 932.07 1242.76 n/a $990.61
2018 IL L5960 D PO 932.07 1242.76 n/a $1124.74
2018 IN L5960 D PO 932.07 1242.76 n/a $1124.74
2018 KS L5960 D PO 932.07 1242.76 n/a $1033.53
2018 KY L5960 D PO 932.07 1242.76 n/a $932.07
2018 LA L5960 D PO 932.07 1242.76 n/a $1242.76
2018 MA L5960 D PO 932.07 1242.76 n/a $1038.88
2018 MD L5960 D PO 932.07 1242.76 n/a $981.38
2018 ME L5960 D PO 932.07 1242.76 n/a $1038.88
2018 MI L5960 D PO 932.07 1242.76 n/a $1124.74
2018 MN L5960 D PO 932.07 1242.76 n/a $1124.74
2018 MO L5960 D PO 932.07 1242.76 n/a $1033.53
2018 MS L5960 D PO 932.07 1242.76 n/a $932.07
2018 MT L5960 D PO 932.07 1242.76 n/a $932.07
2018 NC L5960 D PO 932.07 1242.76 n/a $932.07
2018 ND L5960 D PO 932.07 1242.76 n/a $932.07
2018 NE L5960 D PO 932.07 1242.76 n/a $1033.53
2018 NH L5960 D PO 932.07 1242.76 n/a $1038.88
2018 NJ L5960 D PO 932.07 1242.76 n/a $1237.32
2018 NM L5960 D PO 932.07 1242.76 n/a $1242.76
2018 NV L5960 D PO 932.07 1242.76 n/a $932.07
2018 NY L5960 D PO 932.07 1242.76 n/a $1237.32
2018 OH L5960 D PO 932.07 1242.76 n/a $1124.74
2018 OK L5960 D PO 932.07 1242.76 n/a $1242.76
2018 OR L5960 D PO 932.07 1242.76 n/a $990.61
2018 PA L5960 D PO 932.07 1242.76 n/a $981.38
2018 PR L5960 D PO 932.07 1242.76 n/a $1841.57
2018 RI L5960 D PO 932.07 1242.76 n/a $1038.88
2018 SC L5960 D PO 932.07 1242.76 n/a $932.07
2018 SD L5960 D PO 932.07 1242.76 n/a $932.07
2018 TN L5960 D PO 932.07 1242.76 n/a $932.07
2018 TX L5960 D PO 932.07 1242.76 n/a $1242.76
2018 UT L5960 D PO 932.07 1242.76 n/a $932.07
2018 VA L5960 D PO 932.07 1242.76 n/a $981.38
2018 VI L5960 D PO 932.07 1242.76 n/a $1237.31
2018 VT L5960 D PO 932.07 1242.76 n/a $1038.88
2018 WA L5960 D PO 932.07 1242.76 n/a $990.61
2018 WI L5960 D PO 932.07 1242.76 n/a $1124.74
2018 WV L5960 D PO 932.07 1242.76 n/a $981.38
2018 WY L5960 D PO 932.07 1242.76 n/a $932.07

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