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K0041 — Large size footplate, each

HCPCS Level II K-code · short descriptor: “Large size footplate each”

Code system
HCPCS Level II
Family
K — DME MAC temporary codes
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Inexpensive or routinely purchased
Prior authorization
Not on Medicare required-PA list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

K0041 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $60.51 to $69.27 depending on state and rural status.

StateNon-ruralRural
AK$62.23
AL$60.51$62.75
AR$60.51$62.75
AZ$60.51$62.23
CA$60.51$62.23
CO$60.51$62.75
CT$60.51$62.75
DC$60.51$62.75
DE$60.51$62.75
FL$60.51$62.75
GA$60.51$62.75
HI$62.23
IA$60.51$62.23
ID$60.51$62.23
IL$60.51$62.75
IN$60.51$62.75
KS$60.51$62.23
KY$60.51$62.75
LA$60.51$62.75
MA$60.51$62.75
MD$60.51$62.75
ME$60.51$62.75
MI$60.51$62.75
MN$60.51$62.75
MO$60.51$62.75
MS$60.51$62.75
MT$60.51$62.23
NC$60.51$62.75
ND$60.51$62.23
NE$60.51$62.23
NH$60.51$62.75
NJ$60.51$62.75
NM$60.51$62.75
NV$60.51$62.23
NY$60.51$62.75
OH$60.51$62.75
OK$60.51$62.75
OR$60.51$62.23
PA$60.51$62.75
PR$69.27
RI$60.51$62.75
SC$60.51$62.75
SD$60.51$62.23
TN$60.51$62.75
TX$60.51$62.75
UT$60.51$62.75
VA$60.51$62.75
VI$62.75
VT$60.51$62.75
WA$60.51$62.75
WI$60.51$62.75
WV$60.51$62.75
WY$60.51$62.23

NU + KE — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $66.87 to $74.92 depending on state and rural status.

StateNon-ruralRural
AK$66.87
AL$67.46
AR$67.46
AZ$66.87
CA$66.87
CO$67.46
CT$67.46
DC$67.46
DE$67.46
FL$67.46
GA$67.46
HI$66.87
IA$66.87
ID$66.87
IL$67.46
IN$67.46
KS$66.87
KY$67.46
LA$67.46
MA$67.46
MD$67.46
ME$67.46
MI$67.46
MN$67.46
MO$67.46
MS$67.46
MT$66.87
NC$67.46
ND$66.87
NE$66.87
NH$67.46
NJ$67.46
NM$67.46
NV$66.87
NY$67.46
OH$67.46
OK$67.46
OR$66.87
PA$67.46
PR$74.92
RI$67.46
SC$67.46
SD$66.87
TN$67.46
TX$67.46
UT$67.46
VA$67.46
VI$67.46
VT$67.46
WA$67.46
WI$67.46
WV$67.46
WY$66.87

NU + KU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $63.95 to $78.03 depending on state and rural status.

Former-CBA payment limits: ceiling $64.99 · floor $55.24

StateNon-ruralRural
AK$63.95
AL$64.99
AR$64.99
AZ$63.95
CA$63.95
CO$64.99
CT$64.99
DC$64.99
DE$64.99
FL$64.99
GA$64.99
HI$63.95
IA$63.95
ID$63.95
IL$64.99
IN$64.99
KS$63.95
KY$64.99
LA$64.99
MA$64.99
MD$64.99
ME$64.99
MI$64.99
MN$64.99
MO$64.99
MS$64.99
MT$63.95
NC$64.99
ND$63.95
NE$63.95
NH$64.99
NJ$64.99
NM$64.99
NV$63.95
NY$64.99
OH$64.99
OK$64.99
OR$63.95
PA$64.99
PR$78.03
RI$64.99
SC$64.99
SD$63.95
TN$64.99
TX$64.99
UT$64.99
VA$64.99
VI$64.99
VT$64.99
WA$64.99
WI$64.99
WV$64.99
WY$63.95

RR — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.05 to $6.92 depending on state and rural status.

StateNon-ruralRural
AK$6.22
AL$6.05$6.30
AR$6.05$6.30
AZ$6.05$6.22
CA$6.05$6.22
CO$6.05$6.30
CT$6.05$6.30
DC$6.05$6.30
DE$6.05$6.30
FL$6.05$6.30
GA$6.05$6.30
HI$6.22
IA$6.05$6.22
ID$6.05$6.22
IL$6.05$6.30
IN$6.05$6.30
KS$6.05$6.22
KY$6.05$6.30
LA$6.05$6.30
MA$6.05$6.30
MD$6.05$6.30
ME$6.05$6.30
MI$6.05$6.30
MN$6.05$6.30
MO$6.05$6.30
MS$6.05$6.30
MT$6.05$6.22
NC$6.05$6.30
ND$6.05$6.22
NE$6.05$6.22
NH$6.05$6.30
NJ$6.05$6.30
NM$6.05$6.30
NV$6.05$6.22
NY$6.05$6.30
OH$6.05$6.30
OK$6.05$6.30
OR$6.05$6.22
PA$6.05$6.30
PR$6.92
RI$6.05$6.30
SC$6.05$6.30
SD$6.05$6.22
TN$6.05$6.30
TX$6.05$6.30
UT$6.05$6.30
VA$6.05$6.30
VI$6.30
VT$6.05$6.30
WA$6.05$6.30
WI$6.05$6.30
WV$6.05$6.30
WY$6.05$6.22

RR + KE — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.68 to $7.49 depending on state and rural status.

StateNon-ruralRural
AK$6.68
AL$6.78
AR$6.78
AZ$6.68
CA$6.68
CO$6.78
CT$6.78
DC$6.78
DE$6.78
FL$6.78
GA$6.78
HI$6.68
IA$6.68
ID$6.68
IL$6.78
IN$6.78
KS$6.68
KY$6.78
LA$6.78
MA$6.78
MD$6.78
ME$6.78
MI$6.78
MN$6.78
MO$6.78
MS$6.78
MT$6.68
NC$6.78
ND$6.68
NE$6.68
NH$6.78
NJ$6.78
NM$6.78
NV$6.68
NY$6.78
OH$6.78
OK$6.78
OR$6.68
PA$6.78
PR$7.49
RI$6.78
SC$6.78
SD$6.68
TN$6.78
TX$6.78
UT$6.78
VA$6.78
VI$6.78
VT$6.78
WA$6.78
WI$6.78
WV$6.78
WY$6.68

RR + KU — Monthly rental Inexpensive or routinely purchased

Medicare allowable ranges from $6.39 to $7.79 depending on state and rural status.

Former-CBA payment limits: ceiling $6.56 · floor $5.58

StateNon-ruralRural
AK$6.39
AL$6.56
AR$6.56
AZ$6.39
CA$6.39
CO$6.56
CT$6.56
DC$6.56
DE$6.56
FL$6.56
GA$6.56
HI$6.39
IA$6.39
ID$6.39
IL$6.56
IN$6.56
KS$6.39
KY$6.56
LA$6.56
MA$6.56
MD$6.56
ME$6.56
MI$6.56
MN$6.56
MO$6.56
MS$6.56
MT$6.39
NC$6.56
ND$6.39
NE$6.39
NH$6.56
NJ$6.56
NM$6.56
NV$6.39
NY$6.56
OH$6.56
OK$6.56
OR$6.39
PA$6.56
PR$7.79
RI$6.56
SC$6.56
SD$6.39
TN$6.56
TX$6.56
UT$6.56
VA$6.56
VI$6.56
VT$6.56
WA$6.56
WI$6.56
WV$6.56
WY$6.39

UE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $45.38 to $51.95 depending on state and rural status.

StateNon-ruralRural
AK$46.65
AL$45.38$47.06
AR$45.38$47.06
AZ$45.38$46.65
CA$45.38$46.65
CO$45.38$47.06
CT$45.38$47.06
DC$45.38$47.06
DE$45.38$47.06
FL$45.38$47.06
GA$45.38$47.06
HI$46.65
IA$45.38$46.65
ID$45.38$46.65
IL$45.38$47.06
IN$45.38$47.06
KS$45.38$46.65
KY$45.38$47.06
LA$45.38$47.06
MA$45.38$47.06
MD$45.38$47.06
ME$45.38$47.06
MI$45.38$47.06
MN$45.38$47.06
MO$45.38$47.06
MS$45.38$47.06
MT$45.38$46.66
NC$45.38$47.06
ND$45.38$46.65
NE$45.38$46.65
NH$45.38$47.06
NJ$45.38$47.06
NM$45.38$47.06
NV$45.38$46.65
NY$45.38$47.06
OH$45.38$47.06
OK$45.38$47.06
OR$45.38$46.65
PA$45.38$47.06
PR$51.95
RI$45.38$47.06
SC$45.38$47.06
SD$45.38$46.65
TN$45.38$47.06
TX$45.38$47.06
UT$45.38$47.06
VA$45.38$47.06
VI$47.06
VT$45.38$47.06
WA$45.38$47.06
WI$45.38$47.06
WV$45.38$47.06
WY$45.38$46.65

UE + KE — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $50.12 to $56.19 depending on state and rural status.

StateNon-ruralRural
AK$50.12
AL$50.59
AR$50.59
AZ$50.12
CA$50.12
CO$50.59
CT$50.59
DC$50.59
DE$50.59
FL$50.59
GA$50.59
HI$50.12
IA$50.12
ID$50.12
IL$50.59
IN$50.59
KS$50.12
KY$50.59
LA$50.59
MA$50.59
MD$50.59
ME$50.59
MI$50.59
MN$50.59
MO$50.59
MS$50.59
MT$50.14
NC$50.59
ND$50.12
NE$50.12
NH$50.59
NJ$50.59
NM$50.59
NV$50.12
NY$50.59
OH$50.59
OK$50.59
OR$50.12
PA$50.59
PR$56.19
RI$50.59
SC$50.59
SD$50.12
TN$50.59
TX$50.59
UT$50.59
VA$50.59
VI$50.59
VT$50.59
WA$50.59
WI$50.59
WV$50.59
WY$50.12

UE + KU — Used purchase Inexpensive or routinely purchased

Medicare allowable ranges from $47.92 to $58.52 depending on state and rural status.

Former-CBA payment limits: ceiling $48.74 · floor $41.43

StateNon-ruralRural
AK$47.92
AL$48.74
AR$48.74
AZ$47.92
CA$47.92
CO$48.74
CT$48.74
DC$48.74
DE$48.74
FL$48.74
GA$48.74
HI$47.92
IA$47.92
ID$47.92
IL$48.74
IN$48.74
KS$47.92
KY$48.74
LA$48.74
MA$48.74
MD$48.74
ME$48.74
MI$48.74
MN$48.74
MO$48.74
MS$48.74
MT$47.94
NC$48.74
ND$47.92
NE$47.92
NH$48.74
NJ$48.74
NM$48.74
NV$47.92
NY$48.74
OH$48.74
OK$48.74
OR$47.92
PA$48.74
PR$58.52
RI$48.74
SC$48.74
SD$47.92
TN$48.74
TX$48.74
UT$48.74
VA$48.74
VI$48.74
VT$48.74
WA$48.74
WI$48.74
WV$48.74
WY$47.92
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

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