Medicare DMEPOS Fee Schedule Lookup by State
Medicare does not price durable medical equipment, prosthetics, orthotics or supplies under the Physician Fee Schedule. It uses the DMEPOS fee schedule, which sets one amount per code, modifier and state, with a separate rural amount for many items. Type a code, pick a state and a date of service, and this tool returns the non-rural and rural amounts from the CMS release in force that day, plus every other state. No sign-up, no daily limit.
Non-rural and rural amounts, per state
Source & method
- Amounts: the CMS DMEPOS fee schedule public use file, every quarterly release from January 2023 to July 2026. A date of service is priced under the release CMS had in force that day, and each release names the zip and the file inside it that the amount was read from. The Parenteral and Enteral Nutrition (PEN) schedule ships in the same zips, and CMS reissues it on its own schedule, so a bundle often pairs a July DMEPOS file with January’s PEN file. The tool says which.
- How they are read: CMS publishes each schedule twice, as a text file with one amount per record and as a spreadsheet grid. Amounts are read from the text file, and every one of roughly 187,000 cells per release is compared with the spreadsheet. The only differences are on two very large codes, Q0480 and the ceiling for K1007, where the spreadsheet clamps the amount at 99,999.99 or drops the cents; the text file is used there. CMS corrected the spreadsheet from the July 2025 release, and the two copies have agreed cell for cell since.
- Rural amounts: read only where CMS marks a rural fee as present. A code with no rural fee shows “none”, never $0.00.
- Live source to verify: CMS DMEPOS Fee Schedule.
2026 Medicare DMEPOS amounts, explained
What is the Medicare DMEPOS fee schedule?
The DMEPOS fee schedule is the price list Medicare uses for durable medical equipment, prosthetics, orthotics and supplies. The Centers for Medicare & Medicaid Services publishes it as a public use file and reissues it quarterly, one row per HCPCS code and modifier, with a non-rural and a rural column for every state, the District of Columbia, Puerto Rico and the Virgin Islands. The July 2026 file carries 3,531 DMEPOS rows and 50 PEN rows across 2,157 codes. Every figure on this page is read directly from those files.
What does Medicare pay for common DME items in 2026?
The table below lists July 2026 amounts for six common items in New York and New Jersey. None of the six moved between January and July 2026, which is the usual case: most quarters change a small set of codes rather than the whole file. Each amount is per unit of the code as CMS defines it, so a rental is per month and a supply is per the quantity in its descriptor. Where a state shows a rural amount, it applies when the ZIP code of the address used to price the claim is on CMS’s DMEPOS rural ZIP code file.
| Code | Mod | Item | NY non-rural | NY rural | NJ non-rural | NJ rural |
|---|---|---|---|---|---|---|
| A4216 | Sterile water or saline, 10 ml | $0.55 | none | $0.63 | none | |
| E0601 | RR | CPAP device, rental | $50.04 | $97.02 | $50.04 | $89.86 |
| E0730 | NU | TENS unit, four lead, new | $83.22 | $288.63 | $83.22 | $310.21 |
| K0001 | RR | Standard wheelchair, rental | $26.42 | $52.43 | $26.42 | $53.08 |
| L0650 | Lumbar-sacral orthosis, prefabricated | $809.61 | $1,105.67 | $809.61 | $1,105.67 | |
| B4035 | Enteral feeding supply kit, pump, per day | $6.21 | $11.38 | $6.21 | $11.38 |
Source: CMS DMEPOS fee schedule, July 2026 release (dme26-c.zip, DMEPOS_JUL.txt). B4035 is on the PEN schedule, which CMS last reissued in January 2026 (dme26.zip, DMEPEN26_JAN.txt).
Why the date of service decides the file
DMEPOS amounts change every January, and in 2024 the method itself changed. Through December 31, 2023, CMS paid non-rural areas without competitive bidding a 75/25 blend of adjusted and unadjusted amounts; from January 1, 2024 it pays 100 percent of the adjusted amount. A new TENS unit (E0730-NU) in New York therefore reads $170.42 in the January 2023 file and $78.68 in January 2024, a fall of more than half. The quarters matter too, and in a way a year filter cannot express: a code CMS added in October is simply absent from that January’s file, so pricing it against the wrong quarter returns no amount rather than a wrong one.
Key terms in a DMEPOS fee schedule lookup
- Non-rural (NR) and rural (R)
- The two amounts CMS publishes per state. Codes not adjusted with competitive bidding information have only a non-rural amount, and that amount applies statewide.
- Modifier
- Part of the price, not a note. NU is a new purchase, RR a rental and UE a used purchase, and each is its own row.
- Ceiling and floor
- National maximum and minimum amounts CMS sets for certain items in the contiguous states. Codes adjusted with competitive bidding information carry neither.
- PEN
- The Parenteral and Enteral Nutrition schedule, published in the same CMS file as DMEPOS, covering B-codes such as enteral feeding supplies.
- Former competitive bidding area
- An area that had a DMEPOS competitive bidding contract. CMS publishes its amounts in separate files, and they are not shown here.
How bill reviewers use DMEPOS amounts
Medical billing experts use the DMEPOS amount to test whether an equipment or supply charge is reasonable. The workflow is to read the code and modifier off the claim, find the state, and price the row under the release CMS had in force on the date of service, then set the total beside the billed charge. Because each figure traces to a published CMS file, it holds up when challenged. For physician and professional codes on the same bill, use the Medicare rate lookup. For New Jersey no-fault claims, see the NJ PIP durable medical equipment schedule. For the full workflow from a stack of bills to a signed report, see Desk.
Medicare DMEPOS rates, answered
Why does a DME code return no rate in a Medicare fee schedule lookup?
Because most Medicare lookups price the Physician Fee Schedule, and durable medical equipment is not paid under it. Of the 2,157 codes on the July 2026 DMEPOS and PEN schedules, 1,531 are not in the Physician Fee Schedule file at all. The other 626 appear there only as status X, P or E, and none of them carries a payable physician rate. The amount lives in a separate CMS file, the DMEPOS fee schedule, so a blank result in a physician tool says nothing about whether Medicare pays for the item.
How does the Medicare DMEPOS fee schedule work?
CMS publishes one amount per HCPCS code, modifier and state, not per payment locality. Many codes carry two amounts in each state: a non-rural amount and a rural amount. Since 2016 CMS has adjusted most equipment amounts using prices from its competitive bidding program, and it publishes a national ceiling and floor for certain items. CMS reissues the schedule quarterly and its transmittal names which files changed, so this tool carries all 15 releases from January 2023 and prices a code under the one in force on the date of service.
Does the Medicare DMEPOS fee schedule change during the year?
Yes, on all three counts. CMS adds codes mid-year: 78 codes joined the schedule in an April, July or October release between 2023 and 2026, and pricing one of those against January's file returns no amount at all. It reprices: the July 2025 release moved 1,151 amounts across 100 codes, almost all of them in Alaska, Hawaii, Puerto Rico and the Virgin Islands, where a group 2 power wheelchair (K0808-NU) fell from $4,485.79 to $4,471.54. And it retires codes, four of them mid-year in the same period. Not every quarter brings a new file: the July 2023 transmittal states “No update DMEPOS fee schedule file for July 2023”, so April 2023 amounts stayed in force through September.
What does Medicare pay for A4216, sterile water or saline, 10 ml?
Under the July 2026 DMEPOS fee schedule, A4216 is $0.55 per unit in New York and $0.63 in New Jersey, and the contiguous states range from $0.54 to $0.63. One unit is 10 ml, so a 20-unit line is 200 ml. A4216 has no rural amount in any state, so one figure applies statewide. The January 2025 amounts were $0.54 in New York and $0.62 in New Jersey.
Why is the rural DMEPOS amount so much higher than the non-rural amount?
The two are built differently. CMS states that from January 1, 2024, non-rural amounts outside competitive bidding areas are 100 percent of the amounts adjusted with competitive bidding prices, while rural and non-contiguous areas are paid a 50/50 blend of the adjusted and unadjusted amounts. A CPAP device rental (E0601-RR) in New York shows the gap: $50.04 non-rural against $97.02 rural in July 2026.
Why did some DMEPOS amounts fall sharply between 2023 and 2024?
The blend changed. Through December 31, 2023, non-rural amounts in areas without competitive bidding were 75 percent adjusted and 25 percent unadjusted. From January 1, 2024 they are 100 percent adjusted. A new TENS unit (E0730-NU) in New York went from $170.42 in the January 2023 file to $78.68 in January 2024. Pricing a 2023 item against a 2024 or later file can therefore understate the benchmark by more than half.
What do the NU, RR and UE modifiers mean on a DME bill?
They are separate prices for the same item, and CMS publishes a row for each. NU is a new purchase, RR is a rental and UE is a used purchase. A rental amount is paid per rental month for most items. Some rows add a second modifier, such as KU for items in Competitive Bidding Program Number 3. Always price the row that matches the modifier printed on the claim, because the amounts differ several-fold.