AFO Product DMEPOS By State Fee Schedule 2023
XTERN
Richie Brace
Balance
Dorsiflex
Gauntlet
Traditional
CROW
UNFO
XTERN
Richie Brace
Balance
Dorsiflex
Gauntlet
Traditional
CROW
UNFO
Gauntlet
Traditional
CROW
UNFO
XTERN
Richie Brace
Balance
Dorsiflex
AFO Product DMEPOS By State Fee Schedule 2024
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2.6% increase for 2024
Medicare DME fee schedule explanation
The designation of "floor" and "ceiling" attached to each of the fees in the table pertains to geographic differences in the fee schedule. Some areas of the country will have fees closer to the ceiling and others will have fees closer to the floor. All providers within a certain area should receive the same payment for a given HCPCS code, while other providers in other certain areas will receive a different payment. Your expected payment is based on your geographic location. The 50 states are all administered by one of four DME MACs (Medicare Administrative Contractors). These contractors are different from the administrators of Parts A and B Medicare.
To find your DME MAC, the regions are depicted here.
More information on each region can be found here:
TurboMed XTERN
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
XTERN
L1951 - Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment
1177
882.75
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section.
127.39
95.54
2.60%
2.60%
Total HCPCS
1304.39
978.29
2.60%
2.60%
Tamarack Free Motion
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
A200
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
124.16
95.54
2.60%
2.60%
Total HCPCS
1355.17
1016.38
2.60%
2.60%
Tamarack Free Motion Calf Lacer
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
A200L
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
Total HCPCS
1931.17
1448.38
2.60%
2.60%
Overlap Free Motion
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
A250
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
Total HCPCS
1355.17
1016.38
2.60%
2.60%
Tamarack Dorsi-Assist
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
A300
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2210 - Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
98.6
73.95
2.60%
2.60%
L2210 - Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
98.6
73.95
2.60%
2.60%
Total HCPCS
1552.37
1164.28
2.60%
2.60%
Cabbie
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G50
L1907 - Ankle foot orthosis, plastic or other material, custom fabricated
788.6
591.45
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
Total HCPCS
1364.60
1023.45
2.60%
2.60%
Short
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G100
L1940 - Ankle foot orthosis, plastic or other material, custom fabricated
725.46
544.1
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
Total HCPCS
1428.85
1071.64
2.60%
2.60%
Standard
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G120
L1940 - Ankle foot orthosis, plastic or other material, custom fabricated
725.46
544.1
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
Total HCPCS
1428.85
1071.64
2.60%
2.60%
Tall
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G140
L1940 - Ankle foot orthosis, plastic or other material, custom fabricated
725.46
544.1
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
Total HCPCS
1428.85
1071.64
2.60%
2.60%
Tamarack Free Motion
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G200
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
Total HCPCS
1747.20
1310.40
2.60%
2.60%
Overlapping Articulating Gauntlet
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G250
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
Total HCPCS
1931.17
1448.38
2.60%
2.60%
Tamarack Dorsi-Assist
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G300
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
L2210 - Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
98.6
73.95
2.60%
2.60%
L2210 - Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
98.6
73.95
2.60%
2.60%
Total HCPCS
1944.40
1458.30
2.60%
2.60%
Leather Partial Foot
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G600
L1960 - Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
813.1
609.82
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
L5000 - Partial foot, shoe insert with longitudinal arch, toe filler
789.62
592.22
2.60%
2.60%
Total HCPCS
2306.11
1729.58
2.60%
2.60%
Balance Brace
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
G800
L1940 - Ankle foot orthosis, plastic or other material, custom fabricated
725.46
544.1
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
Total HCPCS
1428.85
1071.64
2.60%
2.60%
Leaf Spring
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
T100
L1960 - Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
813.1
609.82
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
134.48
2.60%
2.60%
Total HCPCS
997.07
747.80
2.60%
2.60%
Solid Ankle
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
T150
L1960 - Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
813.1
609.82
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
Total HCPCS
997.07
747.80
2.60%
2.60%
Tamarack Dorsi-Assist
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
T300
L1970 - Ankle foot orthosis, plastic with ankle joint, custom fabricated
1043.81
782.86
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
L2210 - Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
98.6
73.95
2.60%
2.60%
L2210 - Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
98.6
73.95
2.60%
2.60%
Total HCPCS
1424.98
1068.74
2.60%
2.60%
Traditional CROW
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
C100
L4631 - Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated
2161.43
1621.07
2.60%
2.60%
Total HCPCS
1938.05
1453.53
2.60%
2.60%
Tundra Boot
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
C200
L1960 - Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
813.1
609.82
2.60%
2.60%
L1940 - Ankle foot orthosis, plastic or other material, custom fabricated
725.46
544.1
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2280 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
664.23
498.18
2.60%
2.60%
L2232 - Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only
137.16
102.87
2.60%
2.60%
L3400 - Metatarsal bar wedge, rocker
57.04
42.78
2.60%
2.60%
Total HCPCS
3100.38
2325.29
2.60%
2.60%
Tundra Sandal
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
C250
L1960 - Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
813.1
609.82
2.60%
2.60%
L1940 - Ankle foot orthosis, plastic or other material, custom fabricated
725.46
544.1
2.60%
2.60%
L2330 - Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
576.00
432.00
2.60%
2.60%
L2280 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
664.23
498.18
2.60%
2.60%
L2232 - Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only
137.16
102.87
2.60%
2.60%
L3400 - Metatarsal bar wedge, rocker
57.04
42.78
2.60%
2.60%
Total HCPCS
3100.38
2325.29
2.60%
2.60%
Dorsiflex Posterior
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
D100
L1945 - Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated
1357.91
1018.43
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2755 - Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only
183.12
137.34
2.60%
2.60%
L2755 - Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only
183.12
137.34
2.60%
2.60%
Total HCPCS
1851.54
1388.65
2.60%
2.60%
Dorsiflex Anterior
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
D110
L1945 - Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated
1357.91
1018.43
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2755 - Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only
183.12
137.34
2.60%
2.60%
L2755 - Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only
183.12
137.34
2.60%
2.60%
Total HCPCS
1851.54
1388.65
2.60%
2.60%
HCPCS
CEILING
FLOOR
CEILING % CHANGE
FLOOR % CHANGE
ADDITIONAL
CODES
L2270 - Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad
78.78
59.08
2.60%
2.60%
L2275 - Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
183.97
137.98
2.60%
2.60%
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
127.39
95.54
2.60%
2.60%
L2350 - Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)
1307.1
980.32
2.60%
2.60%
AFO Product DMEPOS By State Fee Schedule 2024