TL;DR
The DME26-D DMEPOS fee schedule, effective October 1, 2026, prices 2,127 HCPCS Level II codes in 3,538 code and modifier rows with a non-rural and a rural amount for each of 53 states and territories. 1,109 rows carry a separate rural amount, which applies only in the 15,907 ZIP codes on the quarter 4 rural ZIP list; Alaska, Hawaii, Puerto Rico and the Virgin Islands are not subject to rural fees.
The October 2026 file in numbers
- HCPCS codes
- 2,127
- 3,538 code and modifier rows
- Payment categories
- 14
- State columns
- 53
- 48 contiguous states and DC, plus AK, HI, PR, VI
- Rows with a rural amount
- 1,109
- 416 codes
- Rural ZIP codes (Q4 2026)
- 15,907
- 46 states
- Rows with a ceiling and floor
- 2,226
- 1,312 rows carry zero
What the DMEPOS fee schedule is
The fee schedule sets the Medicare allowed amount for each HCPCS Level II code a supplier bills for equipment, prosthetic and orthotic devices, surgical dressings, therapeutic shoes, lymphedema compression items and supplies. Medicare pays 80% of the lower of the supplier's charge and the fee schedule amount, after any unmet Part B deductible, and the beneficiary owes the other 20%. The schedule rests on section 1834(a) of the Social Security Act for equipment, added in 1987, and section 1834(h) for prosthetics and orthotics; parenteral and enteral nutrition has its own fee schedule file.
Every row names the contractor jurisdiction for the code. DME MAC jurisdiction (D) covers 3,266 rows; Local Part B MAC jurisdiction (L) covers 142 rows; Joint DME MAC and Part B MAC jurisdiction (J) covers 130 rows. A D row is billed to the DME Medicare Administrative Contractor for the beneficiary's region, an L row to the local Part B contractor, and a J row to either one, depending on the circumstances of the claim. The 6 code ranges in the file are L (863 codes), E (531 codes), A (449 codes), K (105 codes), V (102 codes), Q (77 codes); orthotics and prosthetics (L codes) are the largest by code count, and equipment (E codes) the largest by rows, because each rental and purchase option is its own row.
The 14 payment categories
Each row carries a payment category that decides how the item is paid: purchased, rented, capped at 13 months or paid monthly. Inexpensive and other routinely purchased items (IN) account for 1,642 rows, Prosthetics and orthotics (PO) account for 1,018 rows, Capped rental items (CR) account for 395 rows.
| Category | Name | How it is paid | Codes | Rows |
|---|---|---|---|---|
| IN | Inexpensive and other routinely purchased items | Items of $150 or less, or routinely purchased before 1989; can be bought new or used or rented, but total rental payments cannot exceed the new purchase fee. | 360 | 1,642 |
| PO | Prosthetics and orthotics | Regional purchase fees limited by a national ceiling of 120% and a floor of 90% of the average of the regional statewide fees. | 1,002 | 1,018 |
| CR | Capped rental items | Rented for up to 13 months of continuous use, after which the beneficiary owns the item; rental fees drop after the third month. | 308 | 395 |
| OS | Ostomy, tracheostomy and urological items | Purchase fees calculated like inexpensive items, with a ceiling at the median and a floor at 85% of the median of the local fees. | 164 | 168 |
| SD | Surgical dressings | Statewide amounts limited by a national ceiling and floor. | 91 | 91 |
| LC | Lymphedema compression treatment items | National payment amounts added in 2024 under section 1834(z) of the Social Security Act; not subject to ceilings or floors. | 72 | 72 |
| SC | Splints and casts | Priced from national fee schedule amounts, not subject to ceilings and floors. | 50 | 50 |
| SU | Supplies | Supplies necessary for the effective use of equipment, paid on purchase. | 37 | 39 |
| OX | Oxygen and oxygen equipment | One bundled monthly rental for stationary equipment, contents and accessories; equipment payments stop after 36 months of continuous use. | 19 | 37 |
| TS | Therapeutic shoes | Therapeutic shoes and inserts, priced with the prosthetics and orthotics method. | 10 | 10 |
| FS | Frequently serviced items | Items needing frequent and substantial servicing, rented for as long as they are medically necessary. | 8 | 8 |
| IL | Intraocular lenses | Certain intraocular lenses inserted in a physician's office, priced from national amounts. | 3 | 3 |
| LT | Labor rates | Labor for repairing and servicing equipment, set by the contractors from historic charges and updated by the consumer price index. | 3 | 3 |
| TE | Transcutaneous electrical nerve stimulators | Transcutaneous electrical nerve stimulators. | 2 | 2 |
Non-rural and rural amounts
Each state has two columns: NR (non-rural) and R (rural). Since 2016, CMS has adjusted the fee schedule for many items using the prices suppliers bid in the competitive bidding program. Items furnished to beneficiaries in rural ZIP codes, and in the non-contiguous areas, are paid on a blend of 50% of the adjusted amount and 50% of the unadjusted amount, which is why the rural column is usually higher. 1,109 rows (416 codes) carry a rural amount; for every other code the rural column is zero and the non-rural amount applies everywhere in the state.
Whether a beneficiary is rural is decided by the quarterly DMEPOS rural ZIP code file, not by the rural flag in the physician fee schedule ZIP file. A ZIP code is rural when at least half of its area is outside any metropolitan statistical area, or when it is a low-population area excluded from a competitive bidding area. The quarter 4 2026 list has 15,907 ZIP codes in 46 states, led by Texas (829), Pennsylvania (713), Illinois (686), Iowa (684). The ZIP finder on the fee schedules hub shows both lists for any ZIP code.
Example: E0601-RR in every state
E0601 (Continuous positive airway pressure (cpap) device) rented with modifier RR pays between $50.04 and $52.65 a month in the contiguous states at the non-rural rate, and $86.69 to $97.02 at the rural rate. Its ceiling and floor are both zero, which marks a code adjusted with competitive bidding information.
| State | Non-rural | Rural |
|---|---|---|
| Alaska (AK) | $93.44 | no rural column |
| Alabama (AL) | $51.94 | $97.02 |
| Arkansas (AR) | $51.94 | $86.69 |
| Arizona (AZ) | $50.91 | $97.02 |
| California (CA) | $50.44 | $93.04 |
| Colorado (CO) | $50.90 | $88.53 |
| Connecticut (CT) | $50.89 | $91.19 |
| District of Columbia (DC) | $50.04 | $94.64 |
| Delaware (DE) | $50.04 | $92.32 |
| Florida (FL) | $51.94 | $86.69 |
| Georgia (GA) | $51.94 | $97.02 |
| Hawaii (HI) | $97.97 | no rural column |
| Iowa (IA) | $50.70 | $97.02 |
| Idaho (ID) | $50.90 | $97.02 |
| Illinois (IL) | $52.65 | $97.02 |
| Indiana (IN) | $52.65 | $97.02 |
| Kansas (KS) | $50.70 | $97.02 |
| Kentucky (KY) | $51.94 | $96.84 |
| Louisiana (LA) | $51.94 | $86.69 |
| Massachusetts (MA) | $50.89 | $87.95 |
| Maryland (MD) | $50.04 | $97.02 |
| Maine (ME) | $50.89 | $89.69 |
| Michigan (MI) | $52.65 | $89.77 |
| Minnesota (MN) | $50.70 | $87.90 |
| Missouri (MO) | $50.70 | $97.02 |
| Mississippi (MS) | $51.94 | $90.04 |
| Montana (MT) | $50.90 | $86.69 |
| North Carolina (NC) | $51.94 | $97.02 |
| North Dakota (ND) | $50.70 | $95.80 |
| Nebraska (NE) | $50.70 | $97.02 |
| New Hampshire (NH) | $50.89 | $87.44 |
| New Jersey (NJ) | $50.04 | $89.86 |
| New Mexico (NM) | $50.91 | $97.02 |
| Nevada (NV) | $50.44 | $97.02 |
| New York (NY) | $50.04 | $97.02 |
| Ohio (OH) | $52.65 | $97.02 |
| Oklahoma (OK) | $50.91 | $97.02 |
| Oregon (OR) | $50.44 | $97.02 |
| Pennsylvania (PA) | $50.04 | $91.18 |
| Puerto Rico (PR) | $100.22 | no rural column |
| Rhode Island (RI) | $50.89 | $97.02 |
| South Carolina (SC) | $51.94 | $97.02 |
| South Dakota (SD) | $50.70 | $97.02 |
| Tennessee (TN) | $51.94 | $97.02 |
| Texas (TX) | $50.91 | $91.52 |
| Utah (UT) | $50.90 | $97.02 |
| Virginia (VA) | $51.94 | $91.49 |
| U.S. Virgin Islands (VI) | $96.75 | no rural column |
| Vermont (VT) | $50.89 | $87.74 |
| Washington (WA) | $50.44 | $97.02 |
| Wisconsin (WI) | $52.65 | $94.05 |
| West Virginia (WV) | $51.94 | $95.02 |
| Wyoming (WY) | $50.90 | $97.02 |
Ceilings, floors and the non-contiguous areas
For items that are not adjusted with competitive bidding information, CMS limits the statewide amounts with a national ceiling and floor. For equipment and surgical dressings the ceiling is the median of the statewide amounts and the floor is 85% of that median; for prosthetics and orthotics, which are priced regionally, the ceiling is 120% and the floor 90% of the average of the regional statewide fees. Codes adjusted with competitive bidding information carry zero in both columns, as do items under special payment rules: 2,226 rows in the October file carry a ceiling and 1,312 carry zero. In Alaska, Hawaii, Puerto Rico and the Virgin Islands, amounts for codes not adjusted with competitive bidding information are not subject to ceilings and floors, and none of the four is subject to rural fees.
Modifiers in the fee schedule
The first modifier column separates the ways an item can be supplied; the second marks items tied to the competitive bidding program or oxygen flow rates. A claim that omits the modifier on a code priced by modifier has no matching fee and will not price.
| Modifier | Column | Meaning (CMS DMEREAD) | Rows |
|---|---|---|---|
| RR | First | Rented | 959 |
| NU | First | Purchased, new | 587 |
| UE | First | Purchased, used | 527 |
| KM | First | Replacement of facial prosthesis including new impression/moulage | 8 |
| KN | First | Replacement of facial prosthesis using previous master mold | 8 |
| AW | First | Item furnished with a surgical dressing | 5 |
| AU | First | Urological, ostomy or tracheostomy item | 4 |
| KF | First | Class III device | 4 |
| AV | First | Item furnished with a prosthetic or orthotic device | 3 |
| KU | Second | Item subject to DMEPOS competitive bidding program number 3 | 460 |
| KE | Second | Bid under round 1 of the competitive bidding program, for use with non-competitive bid base equipment | 295 |
| KF | Second | Class III device | 34 |
| QB | Second | Stationary oxygen: daytime-at-rest and night amounts differ, their average exceeds 4 LPM, and portable oxygen is prescribed | 9 |
| QF | Second | Stationary oxygen above 4 LPM with portable oxygen prescribed | 9 |
| KC | Second | Replacement of special power wheelchair interface | 5 |
Most searched DME codes
Monthly US Google searches for the bare code (Google Ads, October 2026) show which equipment codes billers look up most. Ranges are the lowest and highest state amounts in the contiguous states for the first modifier row of each code.
| Code | HCPCS descriptor | Category | Modifier | Non-rural | Rural | Searches / month |
|---|---|---|---|---|---|---|
| A6600 | Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each | LC | none | $3.07 | — | 1,900 |
| E0601 | Continuous positive airway pressure (cpap) device | CR | RR | $50.04–$52.65 | $86.69–$97.02 | 1,600 |
| A4239 | Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service | SU | none | $273.28 | — | 1,300 |
| E0143 | Walker, folding, wheeled, adjustable or fixed height | IN | NU | $55.55–$60.89 | $95.17–$106.25 | 1,300 |
| E1390 | Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate | OX | RR | $94.56–$101.12 | $177.16 | 1,300 |
| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | PO | none | $318.18–$424.24 | — | 1,300 |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | PO | none | $67.37–$89.82 | — | 1,000 |
| E0431 | Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing | OX | RR | $21.24–$22.93 | $31.64 | 880 |
| E0486 | Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment | IN | NU | — | — | 880 |
| E0562 | Humidifier, heated, used with positive airway pressure device | IN | NU | $168.20–$176.47 | $280.29 | 880 |
| L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | PO | none | $455.16–$556.31 | $627.47–$743.90 | 880 |
| L3000 | Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each | PO | none | $376.80–$390.25 | — | 880 |
Former competitive bidding areas
CMS still publishes separate files for the former competitive bidding areas (CBAs). During the gap in the competitive bidding program, items in a former CBA are paid at the single payment amounts that applied there on the last day of the contracts, increased by the consumer price index. The October 2026 files list 16,124 ZIP codes across 130 former areas, a fee schedule of 617 rows for 318 codes, and a national mail-order schedule for 8 diabetic testing supply codes (A4233, A4234, A4235, A4236, A4253, A4256, A4258, A4259), which are billed with modifier KL when delivered by mail.
When DMEPOS claims deny
Equipment claims fail on the same few points: the item is billed with a rental modifier after the capped rental period ended, the modifier on the line does not match a priced row, units exceed the DME supplier MUE, or the documentation does not meet the local coverage determination the DME contractor publishes for the item. The coverage side is on the LCD reference, and the reason and remark codes on the remittance are explained in the denial code reference. Supplies and drugs used with equipment, such as inhalation drugs for nebulizers, are priced from the ASP payment limits rather than this file.
Where QuickIntell fits with DMEPOS payments
Contract management in QuickRCM keeps fee schedules and contract terms with their effective dates and compares expected reimbursement with what was allowed and paid, so a rural, modifier or rental-month variance is reviewed before it is disputed. Payment posting carries the remittance side of the comparison.
Frequently asked questions
What is the DMEPOS fee schedule?
The Medicare fee schedule for durable medical equipment, prosthetics, orthotics and supplies. The October 2026 release (DME26-D) has 2,127 HCPCS codes; Medicare pays 80% of the lower of the supplier's charge and the fee schedule amount, after any unmet deductible, using the amounts for the beneficiary's state.
When does the rural DMEPOS fee apply?
When the item is furnished to a beneficiary whose ZIP code is on the quarterly DMEPOS rural ZIP list (15,907 ZIP codes in quarter 4 of 2026) and the code has a rural amount. That list is not the rural indicator in the physician fee schedule ZIP file, so check the DMEPOS list itself.
What do the ceiling and floor columns mean?
For items not adjusted with competitive bidding information, statewide amounts are limited by a national ceiling and floor. Codes adjusted with competitive bidding information carry zero in both columns, and in Alaska, Hawaii, Puerto Rico and the Virgin Islands amounts for codes not adjusted that way are not subject to ceilings and floors.
Why does the same code appear several times?
Each modifier combination is a separate row: purchased new (NU), rented (RR) and purchased used (UE) have their own amounts, and a second modifier such as KU or KE identifies items tied to the DMEPOS competitive bidding program. 3,538 rows cover 2,127 codes.
Back to the Medicare fee schedules hub or on to the 2026 physician fee schedule.
CMS guidance
Medicare Learning Network publications that CMS issues on this topic, cited by ICN and publication date:
- DMEPOS Competitive Bidding Program: Non-Contract Suppliers(MLN900925, )When a supplier without a competitive bidding contract may still furnish bid items in a competitive bidding area; the program has been in a temporary gap since January 1, 2024.
- DMEPOS Competitive Bidding Program: Physicians & Other Treating Practitioners(MLN900926, )The exception that lets physicians, other treating practitioners and therapists furnish off-the-shelf back and knee braces in a competitive bidding area; the program has been in a temporary gap since January 1, 2024.
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- DMEPOS fee schedule DME26-D, October 2026Version DME26-D (October 2026) · effective 2026-10-01 · file DMEPOS_OCT.csvSHA-256 a2824d58aadf4004…
- DMEPOS rural ZIP code file, quarter 4 2026Version Q4 2026 · effective 2026-10-01 · file DME Rural Zip Code Quarter 4 2026.csvSHA-256 226616fbcbc4ace5…
- Former competitive bidding area fee schedule, October 2026Version DME26-D (October 2026) · effective 2026-10-01 · file Former CBA Fee Schedule File - OCT2026.csvSHA-256 cf01d27f2aa2104b…
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
Disclaimer
Operational reference compiled from the CMS DMEPOS public use files. Fee schedule amounts are Medicare allowed amounts before the deductible and coinsurance; coverage depends on the DME MAC's policies and the documentation. HCPCS Level II descriptors are public domain. Not legal, coding or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.