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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 L5940 D PO 614.10 818.79 n/a $655.19
2026 AL L5940 D PO 614.10 818.79 n/a $614.10
2026 AR L5940 D PO 614.10 818.79 n/a $818.79
2026 AZ L5940 D PO 614.10 818.79 n/a $652.69
2026 CA L5940 D PO 614.10 818.79 n/a $652.69
2026 CO L5940 D PO 614.10 818.79 n/a $818.79
2026 CT L5940 D PO 614.10 818.79 n/a $614.10
2026 DC L5940 D PO 614.10 818.79 n/a $614.10
2026 DE L5940 D PO 614.10 818.79 n/a $614.10
2026 FL L5940 D PO 614.10 818.79 n/a $614.10
2026 GA L5940 D PO 614.10 818.79 n/a $614.10
2026 HI L5940 D PO 614.10 818.79 n/a $700.57
2026 IA L5940 D PO 614.10 818.79 n/a $814.46
2026 ID L5940 D PO 614.10 818.79 n/a $763.50
2026 IL L5940 D PO 614.10 818.79 n/a $614.10
2026 IN L5940 D PO 614.10 818.79 n/a $614.10
2026 KS L5940 D PO 614.10 818.79 n/a $814.46
2026 KY L5940 D PO 614.10 818.79 n/a $614.10
2026 LA L5940 D PO 614.10 818.79 n/a $818.79
2026 MA L5940 D PO 614.10 818.79 n/a $614.10
2026 MD L5940 D PO 614.10 818.79 n/a $614.10
2026 ME L5940 D PO 614.10 818.79 n/a $614.10
2026 MI L5940 D PO 614.10 818.79 n/a $614.10
2026 MN L5940 D PO 614.10 818.79 n/a $614.10
2026 MO L5940 D PO 614.10 818.79 n/a $814.46
2026 MS L5940 D PO 614.10 818.79 n/a $614.10
2026 MT L5940 D PO 614.10 818.79 n/a $818.79
2026 NC L5940 D PO 614.10 818.79 n/a $614.10
2026 ND L5940 D PO 614.10 818.79 n/a $818.79
2026 NE L5940 D PO 614.10 818.79 n/a $814.46
2026 NH L5940 D PO 614.10 818.79 n/a $614.10
2026 NJ L5940 D PO 614.10 818.79 n/a $667.12
2026 NM L5940 D PO 614.10 818.79 n/a $818.79
2026 NV L5940 D PO 614.10 818.79 n/a $652.69
2026 NY L5940 D PO 614.10 818.79 n/a $667.12
2026 OH L5940 D PO 614.10 818.79 n/a $614.10
2026 OK L5940 D PO 614.10 818.79 n/a $818.79
2026 OR L5940 D PO 614.10 818.79 n/a $763.50
2026 PA L5940 D PO 614.10 818.79 n/a $614.10
2026 PR L5940 D PO 614.10 818.79 n/a $1142.13
2026 RI L5940 D PO 614.10 818.79 n/a $614.10
2026 SC L5940 D PO 614.10 818.79 n/a $614.10
2026 SD L5940 D PO 614.10 818.79 n/a $818.79
2026 TN L5940 D PO 614.10 818.79 n/a $614.10
2026 TX L5940 D PO 614.10 818.79 n/a $818.79
2026 UT L5940 D PO 614.10 818.79 n/a $818.79
2026 VA L5940 D PO 614.10 818.79 n/a $614.10
2026 VI L5940 D PO 614.10 818.79 n/a $667.12
2026 VT L5940 D PO 614.10 818.79 n/a $614.10
2026 WA L5940 D PO 614.10 818.79 n/a $763.50
2026 WI L5940 D PO 614.10 818.79 n/a $614.10
2026 WV L5940 D PO 614.10 818.79 n/a $614.10
2026 WY L5940 D PO 614.10 818.79 n/a $818.79
Prosthetics / Orthotics, and Supplies
Year State Code Modifier 2nd Modifier Jurisdiction Category Floor Ceiling Rural Fee Non-rural Fee
2025 AK L5940 D PO 602.05 802.74 n/a $642.34
2025 AL L5940 D PO 602.05 802.74 n/a $602.05
2025 AR L5940 D PO 602.05 802.74 n/a $802.74
2025 AZ L5940 D PO 602.05 802.74 n/a $639.89
2025 CA L5940 D PO 602.05 802.74 n/a $639.89
2025 CO L5940 D PO 602.05 802.74 n/a $802.74
2025 CT L5940 D PO 602.05 802.74 n/a $602.05
2025 DC L5940 D PO 602.05 802.74 n/a $602.05
2025 DE L5940 D PO 602.05 802.74 n/a $602.05
2025 FL L5940 D PO 602.05 802.74 n/a $602.05
2025 GA L5940 D PO 602.05 802.74 n/a $602.05
2025 HI L5940 D PO 602.05 802.74 n/a $686.83
2025 IA L5940 D PO 602.05 802.74 n/a $798.49
2025 ID L5940 D PO 602.05 802.74 n/a $748.53
2025 IL L5940 D PO 602.05 802.74 n/a $602.05
2025 IN L5940 D PO 602.05 802.74 n/a $602.05
2025 KS L5940 D PO 602.05 802.74 n/a $798.49
2025 KY L5940 D PO 602.05 802.74 n/a $602.05
2025 LA L5940 D PO 602.05 802.74 n/a $802.74
2025 MA L5940 D PO 602.05 802.74 n/a $602.05
2025 MD L5940 D PO 602.05 802.74 n/a $602.05
2025 ME L5940 D PO 602.05 802.74 n/a $602.05
2025 MI L5940 D PO 602.05 802.74 n/a $602.05
2025 MN L5940 D PO 602.05 802.74 n/a $602.05
2025 MO L5940 D PO 602.05 802.74 n/a $798.49
2025 MS L5940 D PO 602.05 802.74 n/a $602.05
2025 MT L5940 D PO 602.05 802.74 n/a $802.74
2025 NC L5940 D PO 602.05 802.74 n/a $602.05
2025 ND L5940 D PO 602.05 802.74 n/a $802.74
2025 NE L5940 D PO 602.05 802.74 n/a $798.49
2025 NH L5940 D PO 602.05 802.74 n/a $602.05
2025 NJ L5940 D PO 602.05 802.74 n/a $654.04
2025 NM L5940 D PO 602.05 802.74 n/a $802.74
2025 NV L5940 D PO 602.05 802.74 n/a $639.89
2025 NY L5940 D PO 602.05 802.74 n/a $654.04
2025 OH L5940 D PO 602.05 802.74 n/a $602.05
2025 OK L5940 D PO 602.05 802.74 n/a $802.74
2025 OR L5940 D PO 602.05 802.74 n/a $748.53
2025 PA L5940 D PO 602.05 802.74 n/a $602.05
2025 PR L5940 D PO 602.05 802.74 n/a $1119.74
2025 RI L5940 D PO 602.05 802.74 n/a $602.05
2025 SC L5940 D PO 602.05 802.74 n/a $602.05
2025 SD L5940 D PO 602.05 802.74 n/a $802.74
2025 TN L5940 D PO 602.05 802.74 n/a $602.05
2025 TX L5940 D PO 602.05 802.74 n/a $802.74
2025 UT L5940 D PO 602.05 802.74 n/a $802.74
2025 VA L5940 D PO 602.05 802.74 n/a $602.05
2025 VI L5940 D PO 602.05 802.74 n/a $654.04
2025 VT L5940 D PO 602.05 802.74 n/a $602.05
2025 WA L5940 D PO 602.05 802.74 n/a $748.53
2025 WI L5940 D PO 602.05 802.74 n/a $602.05
2025 WV L5940 D PO 602.05 802.74 n/a $602.05
2025 WY L5940 D PO 602.05 802.74 n/a $802.74

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