MyMedi-AI

L1700 — Legg perthes orthosis, (toronto type), custom fabricated

HCPCS Level II L-code · short descriptor: “Leg perthes orth toronto typ”

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
Face-to-face & WOPD
Not on the required list
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L1700 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1754.84 to $3351.80 depending on state and rural status.

Former-CBA payment limits: ceiling $2339.78 · floor $1754.84

StateNon-ruralRural
AK$3134.54—
AL$1987.82—
AR$1971.13—
AZ$2339.78—
CA$2339.78—
CO$1754.84—
CT$2229.88—
DC$1754.84—
DE$1754.84—
FL$1987.82—
GA$1987.82—
HI$3351.80—
IA$1920.58—
ID$1887.33—
IL$1912.04—
IN$1912.04—
KS$1920.58—
KY$1987.82—
LA$1971.13—
MA$2229.88—
MD$1754.84—
ME$2229.88—
MI$1912.04—
MN$1912.04—
MO$1920.58—
MS$1987.82—
MT$1754.84—
NC$1987.82—
ND$1754.84—
NE$1920.58—
NH$2229.88—
NJ$1754.84—
NM$1971.13—
NV$2339.78—
NY$1754.84—
OH$1912.04—
OK$1971.13—
OR$1887.33—
PA$1754.84—
PR$1808.36—
RI$2229.88—
SC$1987.82—
SD$1754.84—
TN$1987.82—
TX$1971.13—
UT$1754.84—
VA$1754.84—
VI$1754.84—
VT$2229.88—
WA$1887.33—
WI$1912.04—
WV$1754.84—
WY$1754.84—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L1700 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

Related L-codes

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