L1600 — Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise
HCPCS Level II L-code · short descriptor: “Ho flex frejka w/cov pre cst”
- Code system
- HCPCS Level II
- Family
- L — Orthotics & prosthetics
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Prosthetics & orthotics
- 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.
L1600 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $148.08 to $329.89 depending on state and rural status.
Former-CBA payment limits: ceiling $197.44 · floor $148.08
| State | Non-rural | Rural |
|---|---|---|
| AK | $189.08 | — |
| AL | $148.08 | — |
| AR | $197.44 | — |
| AZ | $188.16 | — |
| CA | $188.16 | — |
| CO | $151.44 | — |
| CT | $177.94 | — |
| DC | $148.08 | — |
| DE | $148.08 | — |
| FL | $148.08 | — |
| GA | $148.08 | — |
| HI | $202.20 | — |
| IA | $148.08 | — |
| ID | $148.08 | — |
| IL | $158.37 | — |
| IN | $158.37 | — |
| KS | $148.08 | — |
| KY | $148.08 | — |
| LA | $197.44 | — |
| MA | $177.94 | — |
| MD | $148.08 | — |
| ME | $177.94 | — |
| MI | $158.37 | — |
| MN | $158.37 | — |
| MO | $148.08 | — |
| MS | $148.08 | — |
| MT | $151.44 | — |
| NC | $148.08 | — |
| ND | $151.44 | — |
| NE | $148.08 | — |
| NH | $177.94 | — |
| NJ | $148.08 | — |
| NM | $197.44 | — |
| NV | $188.16 | — |
| NY | $148.08 | — |
| OH | $158.37 | — |
| OK | $197.44 | — |
| OR | $148.08 | — |
| PA | $148.08 | — |
| PR | $329.89 | — |
| RI | $177.94 | — |
| SC | $148.08 | — |
| SD | $151.44 | — |
| TN | $148.08 | — |
| TX | $197.44 | — |
| UT | $151.44 | — |
| VA | $148.08 | — |
| VI | $148.08 | — |
| VT | $177.94 | — |
| WA | $148.08 | — |
| WI | $158.37 | — |
| WV | $148.08 | — |
| WY | $151.44 | — |
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.
Common denial codes to watch
Related L-codes
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