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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
2026 AK L0627 D PO 451.40 601.87 n/a $493.08
2026 AL L0627 D PO 451.40 601.87 n/a $507.93
2026 AR L0627 D PO 451.40 601.87 n/a $507.88
2026 AZ L0627 D PO 451.40 601.87 n/a $493.08
2026 CA L0627 D PO 451.40 601.87 n/a $493.08
2026 CO L0627 D PO 451.40 601.87 n/a $511.72
2026 CT L0627 D PO 451.40 601.87 n/a $493.08
2026 DC L0627 D PO 451.40 601.87 n/a $493.08
2026 DE L0627 D PO 451.40 601.87 n/a $493.08
2026 FL L0627 D PO 451.40 601.87 n/a $507.93
2026 GA L0627 D PO 451.40 601.87 n/a $507.93
2026 HI L0627 D PO 451.40 601.87 n/a $493.08
2026 IA L0627 D PO 451.40 601.87 n/a $502.69
2026 ID L0627 D PO 451.40 601.87 n/a $493.08
2026 IL L0627 D PO 451.40 601.87 n/a $505.13
2026 IN L0627 D PO 451.40 601.87 n/a $505.13
2026 KS L0627 D PO 451.40 601.87 n/a $502.69
2026 KY L0627 D PO 451.40 601.87 n/a $507.93
2026 LA L0627 D PO 451.40 601.87 n/a $507.88
2026 MA L0627 D PO 451.40 601.87 n/a $493.08
2026 MD L0627 D PO 451.40 601.87 n/a $493.08
2026 ME L0627 D PO 451.40 601.87 n/a $493.08
2026 MI L0627 D PO 451.40 601.87 n/a $505.13
2026 MN L0627 D PO 451.40 601.87 n/a $505.13
2026 MO L0627 D PO 451.40 601.87 n/a $502.69
2026 MS L0627 D PO 451.40 601.87 n/a $507.93
2026 MT L0627 D PO 451.40 601.87 n/a $511.72
2026 NC L0627 D PO 451.40 601.87 n/a $507.93
2026 ND L0627 D PO 451.40 601.87 n/a $511.72
2026 NE L0627 D PO 451.40 601.87 n/a $502.69
2026 NH L0627 D PO 451.40 601.87 n/a $493.08
2026 NJ L0627 D PO 451.40 601.87 n/a $493.08
2026 NM L0627 D PO 451.40 601.87 n/a $507.88
2026 NV L0627 D PO 451.40 601.87 n/a $493.08
2026 NY L0627 D PO 451.40 601.87 n/a $493.08
2026 OH L0627 D PO 451.40 601.87 n/a $505.13
2026 OK L0627 D PO 451.40 601.87 n/a $507.88
2026 OR L0627 D PO 451.40 601.87 n/a $493.08
2026 PA L0627 D PO 451.40 601.87 n/a $493.08
2026 PR L0627 D PO 451.40 601.87 n/a $542.36
2026 RI L0627 D PO 451.40 601.87 n/a $493.08
2026 SC L0627 D PO 451.40 601.87 n/a $507.93
2026 SD L0627 D PO 451.40 601.87 n/a $511.72
2026 TN L0627 D PO 451.40 601.87 n/a $507.93
2026 TX L0627 D PO 451.40 601.87 n/a $507.88
2026 UT L0627 D PO 451.40 601.87 n/a $511.72
2026 VA L0627 D PO 451.40 601.87 n/a $493.08
2026 VI L0627 D PO 451.40 601.87 n/a $542.36
2026 VT L0627 D PO 451.40 601.87 n/a $493.08
2026 WA L0627 D PO 451.40 601.87 n/a $493.08
2026 WI L0627 D PO 451.40 601.87 n/a $505.13
2026 WV L0627 D PO 451.40 601.87 n/a $493.08
2026 WY L0627 D PO 451.40 601.87 n/a $511.72
Prosthetics / Orthotics, and Supplies
Year State Code Modifier 2nd Modifier Jurisdiction Category Floor Ceiling Rural Fee Non-rural Fee
2025 AK L0627 D PO 442.55 590.07 n/a $483.41
2025 AL L0627 D PO 442.55 590.07 n/a $497.97
2025 AR L0627 D PO 442.55 590.07 n/a $497.92
2025 AZ L0627 D PO 442.55 590.07 n/a $483.41
2025 CA L0627 D PO 442.55 590.07 n/a $483.41
2025 CO L0627 D PO 442.55 590.07 n/a $501.69
2025 CT L0627 D PO 442.55 590.07 n/a $483.41
2025 DC L0627 D PO 442.55 590.07 n/a $483.41
2025 DE L0627 D PO 442.55 590.07 n/a $483.41
2025 FL L0627 D PO 442.55 590.07 n/a $497.97
2025 GA L0627 D PO 442.55 590.07 n/a $497.97
2025 HI L0627 D PO 442.55 590.07 n/a $483.41
2025 IA L0627 D PO 442.55 590.07 n/a $492.83
2025 ID L0627 D PO 442.55 590.07 n/a $483.41
2025 IL L0627 D PO 442.55 590.07 n/a $495.23
2025 IN L0627 D PO 442.55 590.07 n/a $495.23
2025 KS L0627 D PO 442.55 590.07 n/a $492.83
2025 KY L0627 D PO 442.55 590.07 n/a $497.97
2025 LA L0627 D PO 442.55 590.07 n/a $497.92
2025 MA L0627 D PO 442.55 590.07 n/a $483.41
2025 MD L0627 D PO 442.55 590.07 n/a $483.41
2025 ME L0627 D PO 442.55 590.07 n/a $483.41
2025 MI L0627 D PO 442.55 590.07 n/a $495.23
2025 MN L0627 D PO 442.55 590.07 n/a $495.23
2025 MO L0627 D PO 442.55 590.07 n/a $492.83
2025 MS L0627 D PO 442.55 590.07 n/a $497.97
2025 MT L0627 D PO 442.55 590.07 n/a $501.69
2025 NC L0627 D PO 442.55 590.07 n/a $497.97
2025 ND L0627 D PO 442.55 590.07 n/a $501.69
2025 NE L0627 D PO 442.55 590.07 n/a $492.83
2025 NH L0627 D PO 442.55 590.07 n/a $483.41
2025 NJ L0627 D PO 442.55 590.07 n/a $483.41
2025 NM L0627 D PO 442.55 590.07 n/a $497.92
2025 NV L0627 D PO 442.55 590.07 n/a $483.41
2025 NY L0627 D PO 442.55 590.07 n/a $483.41
2025 OH L0627 D PO 442.55 590.07 n/a $495.23
2025 OK L0627 D PO 442.55 590.07 n/a $497.92
2025 OR L0627 D PO 442.55 590.07 n/a $483.41
2025 PA L0627 D PO 442.55 590.07 n/a $483.41
2025 PR L0627 D PO 442.55 590.07 n/a $531.73
2025 RI L0627 D PO 442.55 590.07 n/a $483.41
2025 SC L0627 D PO 442.55 590.07 n/a $497.97
2025 SD L0627 D PO 442.55 590.07 n/a $501.69
2025 TN L0627 D PO 442.55 590.07 n/a $497.97
2025 TX L0627 D PO 442.55 590.07 n/a $497.92
2025 UT L0627 D PO 442.55 590.07 n/a $501.69
2025 VA L0627 D PO 442.55 590.07 n/a $483.41
2025 VI L0627 D PO 442.55 590.07 n/a $531.73
2025 VT L0627 D PO 442.55 590.07 n/a $483.41
2025 WA L0627 D PO 442.55 590.07 n/a $483.41
2025 WI L0627 D PO 442.55 590.07 n/a $495.23
2025 WV L0627 D PO 442.55 590.07 n/a $483.41
2025 WY L0627 D PO 442.55 590.07 n/a $501.69

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