ABCDEFGHIJ
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AFO Product DMEPOS By State Fee Schedule
2020 and 2022 Comparison
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20202022
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HCPCSDescriptionCeilingFloorCeilingFloor
Ceiling % Change
Floor % Change
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Richie Brace
5
L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
6
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section.108.4681.35114.2285.675.3107%5.3104%
7
Total HCPCS997.20747.901050.15787.625.3099%5.3109%
8
9
XTERN
10
L1951Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment1002.14751.611055.35791.515.3096%5.3086%
11
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section.108.4681.35114.2285.675.3107%5.3104%
12
Total HCPCS1110.60832.961169.57877.185.3097%5.3088%
13
14
A200Tamarack Free
Motion
15
L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
16
L2275Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined156.65117.48164.96123.725.3048%5.3115%
17
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
18
Total HCPCS1153.85865.381215.11911.345.3092%5.3110%
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20
A200LTamarack
Free Motion Calf
Lacer
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L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
22
L2275Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined156.65117.48164.96123.725.3048%5.3115%
23
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
24
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
25
Total HCPCS1644.281233.201731.581298.695.3093%5.3106%
26
27
A250Overlap Free
Motion
61.26
28
L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
29
L2275Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined156.65117.48164.96123.725.3048%5.3115%
30
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
31
Total HCPCS1153.85865.381215.11911.345.3092%5.3110%
32
33
A300Tamarack
Dorsi-Assist
34
L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
35
L2275Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined156.65117.48164.96123.725.3048%5.3115%
36
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
37
L2210Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint.83.9662.9788.4166.315.3001%5.3041%
38
L2210Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint.83.9662.9788.4166.315.3001%5.3041%
39
Total HCPCS1321.77991.321391.931043.965.3080%5.3101%
40
41
G50Cabbie
42
L1907Ankle foot orthosis, plastic or other material, custom fabricated.671.44503.58707.10530.325.3110%5.3100%
43
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
44
Total HCPCS1161.87871.401223.57917.675.3104%5.3098%
45
1742.80
46
G100Short
47
L1940Ankle foot orthosis, plastic or other material, custom fabricated.617.68463.26650.48487.865.3102%5.3102%
48
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
49
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
50
Total HCPCS1216.57912.431281.17960.885.3100%5.3100%
51
52
G120Standard
53
L1940Ankle foot orthosis, plastic or other material, custom fabricated.617.68463.26650.48487.865.3102%5.3102%
54
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
55
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
56
Total HCPCS1216.57912.431281.17960.885.3100%5.3100%
57
58
G140Tall
59
L1940Ankle foot orthosis, plastic or other material, custom fabricated.617.68463.26650.48487.865.3102%5.3102%
60
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
61
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
62
Total HCPCS1216.57912.431281.17960.885.3100%5.3100%
63
64
G200Tamarack
Free Motion
65
L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
66
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
67
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
68
Total HCPCS1487.631115.721566.621174.975.3098%5.3105%
69
70
G250
Overlapping
Articulating Gauntlet
71
L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
72
L2275Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined156.65117.48164.96123.725.3048%5.3115%
73
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
74
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
75
Total HCPCS1644.281233.201731.581298.695.3093%5.3106%
76
77
G300Tamarack
Dorsi-Assist
78
L1970Ankle foot orthosis, plastic with ankle joint, custom fabricated888.74666.55935.93701.955.3098%5.3109%
79
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
80
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
81
L2210Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint83.9662.9788.4166.315.3001%5.3041%
82
L2210Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint83.9662.9788.4166.315.3001%5.3041%
83
Total HCPCS1655.551241.661743.441307.595.3088%5.3098%
84
85
G600Leather Partial
Foot
86
L1960Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated692.30519.23729.06546.805.3098%5.3098%
87
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
88
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
89
L5000Partial foot, shoe insert with longitudinal arch, toe filler672.31504.24708.02531.015.3115%5.3090%
90
Total HCPCS1963.501472.642067.771550.835.3104%5.3095%
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92
93
G800Balance Brace
94
L1940Ankle foot orthosis, plastic or other material, custom fabricated.617.68463.26650.48487.865.3102%5.3102%
95
L2820Addition to lower extremity orthosis, soft interface for molded plastic, below knee section108.4681.35114.2285.675.3107%5.3104%
96
L2330Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only.490.43367.82516.47387.355.3096%5.3097%
97
Total HCPCS1216.57912.431281.17960.885.3100%5.3100%
98
99
T100Leaf Spring
100
L1960Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated692.30519.23729.06546.805.3098%5.3098%