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1 | AFO Product DMEPOS By State Fee Schedule 2021, 2022 and 2023 Comparison | ||||||||||||
2 | 2023 | 2022-2023 Comparison | 2022 | 2021 | |||||||||
3 | HCPCS | Description | Ceiling | Floor | Ceiling % Change | Floor % Change | Ceiling | Floor | Ceiling | Floor | |||
4 | Richie Brace | ||||||||||||
5 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
6 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section. | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
7 | Total HCPCS | 1141.52 | 856.14 | 8.70% | 8.70% | 1050.15 | 787.62 | 999.19 | 749.40 | ||||
8 | |||||||||||||
9 | XTERN | ||||||||||||
10 | L1951 | Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment | 1147.17 | 860.38 | 8.70% | 8.70% | 1055.35 | 791.51 | 1004.14 | 753.11 | |||
11 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section. | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
12 | Total HCPCS | 1271.33 | 953.50 | 8.70% | 8.70% | 1169.57 | 877.18 | 1112.82 | 834.62 | ||||
13 | |||||||||||||
14 | A200 | Tamarack Free Motion | |||||||||||
15 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
16 | L2275 | Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined | 179.31 | 134.48 | 8.70% | 8.70% | 164.96 | 123.72 | 156.96 | 117.72 | |||
17 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
18 | Total HCPCS | 1320.83 | 990.62 | 8.70% | 8.70% | 1215.11 | 911.34 | 1156.15 | 867.12 | ||||
19 | |||||||||||||
20 | A200L | Tamarack
Free Motion Calf Lacer | |||||||||||
21 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
22 | L2275 | Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined | 179.31 | 134.48 | 8.70% | 8.70% | 164.96 | 123.72 | 156.96 | 117.72 | |||
23 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
24 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
25 | Total HCPCS | 1882.23 | 1411.67 | 8.70% | 8.70% | 1731.58 | 1298.69 | 1647.56 | 1235.67 | ||||
26 | |||||||||||||
27 | A250 | Overlap Free
Motion | |||||||||||
28 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
29 | L2275 | Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined | 179.31 | 134.48 | 8.70% | 8.70% | 164.96 | 123.72 | 156.96 | 117.72 | |||
30 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
31 | Total HCPCS | 1320.83 | 990.62 | 8.70% | 8.70% | 1215.11 | 911.34 | 1156.15 | 867.12 | ||||
32 | |||||||||||||
33 | A300 | Tamarack
Dorsi-Assist | |||||||||||
34 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
35 | L2275 | Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined | 179.31 | 134.48 | 8.70% | 8.70% | 164.96 | 123.72 | 156.96 | 117.72 | |||
36 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
37 | L2210 | Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint. | 96.11 | 72.08 | 8.71% | 8.70% | 88.41 | 66.31 | 84.12 | 63.09 | |||
38 | L2210 | Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint. | 96.11 | 72.08 | 8.71% | 8.70% | 88.41 | 66.31 | 84.12 | 63.09 | |||
39 | Total HCPCS | 1513.05 | 1134.78 | 8.70% | 8.70% | 1391.93 | 1043.96 | 1324.39 | 993.30 | ||||
40 | |||||||||||||
41 | G50 | Cabbie | |||||||||||
42 | L1907 | Ankle foot orthosis, plastic or other material, custom fabricated. | 768.61 | 576.46 | 8.70% | 8.70% | 707.10 | 530.32 | 672.78 | 504.59 | |||
43 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
44 | Total HCPCS | 1330.01 | 997.51 | 8.70% | 8.70% | 1223.57 | 917.67 | 1164.19 | 873.14 | ||||
45 | 1835.34 | ||||||||||||
46 | G100 | Short | |||||||||||
47 | L1940 | Ankle foot orthosis, plastic or other material, custom fabricated. | 707.08 | 530.31 | 8.70% | 8.70% | 650.48 | 487.86 | 618.92 | 464.19 | |||
48 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
49 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
50 | Total HCPCS | 1392.64 | 1044.48 | 8.70% | 8.70% | 1281.17 | 960.88 | 1219.01 | 914.25 | ||||
51 | |||||||||||||
52 | G120 | Standard | |||||||||||
53 | L1940 | Ankle foot orthosis, plastic or other material, custom fabricated. | 707.08 | 530.31 | 8.70% | 8.70% | 650.48 | 487.86 | 618.92 | 464.19 | |||
54 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
55 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
56 | Total HCPCS | 1392.64 | 1044.48 | 8.70% | 8.70% | 1281.17 | 960.88 | 1219.01 | 914.25 | ||||
57 | |||||||||||||
58 | G140 | Tall | |||||||||||
59 | L1940 | Ankle foot orthosis, plastic or other material, custom fabricated. | 707.08 | 530.31 | 8.70% | 8.70% | 650.48 | 487.86 | 618.92 | 464.19 | |||
60 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
61 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
62 | Total HCPCS | 1392.64 | 1044.48 | 8.70% | 8.70% | 1281.17 | 960.88 | 1219.01 | 914.25 | ||||
63 | |||||||||||||
64 | G200 | Tamarack
Free Motion | |||||||||||
65 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
66 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
67 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
68 | Total HCPCS | 1702.92 | 1277.19 | 8.70% | 8.70% | 1566.62 | 1174.97 | 1490.60 | 1117.95 | ||||
69 | |||||||||||||
70 | G250 | Overlapping
Articulating Gauntlet | |||||||||||
71 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
72 | L2275 | Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined | 179.31 | 134.48 | 8.70% | 8.70% | 164.96 | 123.72 | 156.96 | 117.72 | |||
73 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
74 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
75 | Total HCPCS | 1882.23 | 1411.67 | 8.70% | 8.70% | 1731.58 | 1298.69 | 1647.56 | 1235.67 | ||||
76 | |||||||||||||
77 | G300 | Tamarack
Dorsi-Assist | |||||||||||
78 | L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | 1017.36 | 763.02 | 8.70% | 8.70% | 935.93 | 701.95 | 890.51 | 667.89 | |||
79 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
80 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
81 | L2210 | Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint | 96.11 | 72.08 | 8.71% | 8.70% | 88.41 | 66.31 | 84.12 | 63.09 | |||
82 | L2210 | Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint | 96.11 | 72.08 | 8.71% | 8.70% | 88.41 | 66.31 | 84.12 | 63.09 | |||
83 | Total HCPCS | 1895.14 | 1421.35 | 8.70% | 8.70% | 1743.44 | 1307.59 | 1658.84 | 1244.13 | ||||
84 | |||||||||||||
85 | G600 | Leather Partial
Foot | |||||||||||
86 | L1960 | Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated | 792.49 | 594.37 | 8.70% | 8.70% | 729.06 | 546.80 | 693.69 | 520.27 | |||
87 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
88 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
89 | L5000 | Partial foot, shoe insert with longitudinal arch, toe filler | 769.61 | 577.21 | 8.70% | 8.70% | 708.02 | 531.01 | 673.66 | 505.24 | |||
90 | Total HCPCS | 2247.66 | 1685.75 | 8.70% | 8.70% | 2067.77 | 1550.83 | 1967.44 | 1475.57 | ||||
91 | |||||||||||||
92 | |||||||||||||
93 | G800 | Balance Brace | |||||||||||
94 | L1940 | Ankle foot orthosis, plastic or other material, custom fabricated. | 707.08 | 530.31 | 8.70% | 8.70% | 650.48 | 487.86 | 618.92 | 464.19 | |||
95 | L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | 124.16 | 93.12 | 8.70% | 8.70% | 114.22 | 85.67 | 108.68 | 81.51 | |||
96 | L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only. | 561.40 | 421.05 | 8.70% | 8.70% | 516.47 | 387.35 | 491.41 | 368.55 | |||
97 | Total HCPCS | 1392.64 | 1044.48 | 8.70% | 8.70% | 1281.17 | 960.88 | 1219.01 | 914.25 | ||||
98 | |||||||||||||
99 | T100 | Leaf Spring | |||||||||||
100 | L1960 | Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated | 792.49 | 594.37 | 8.70% | 8.70% | 729.06 | 546.80 | 693.69 | 520.27 |