MyMedi-AI

L1710 — Legg perthes orthosis, (newington type), custom fabricated

HCPCS Level II L-code · short descriptor: “Legg perthes orth newington”

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.

L1710 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $2054.23 to $3711.50 depending on state and rural status.

Former-CBA payment limits: ceiling $2738.97 · floor $2054.23

StateNon-ruralRural
AK$3470.95—
AL$2336.55—
AR$2534.68—
AZ$2738.97—
CA$2738.97—
CO$2054.23—
CT$2738.97—
DC$2054.23—
DE$2054.23—
FL$2336.55—
GA$2336.55—
HI$3711.50—
IA$2054.23—
ID$2283.45—
IL$2434.79—
IN$2434.79—
KS$2054.23—
KY$2336.55—
LA$2534.68—
MA$2738.97—
MD$2054.23—
ME$2738.97—
MI$2434.79—
MN$2434.79—
MO$2054.23—
MS$2336.55—
MT$2054.23—
NC$2336.55—
ND$2054.23—
NE$2054.23—
NH$2738.97—
NJ$2054.23—
NM$2534.68—
NV$2738.97—
NY$2054.23—
OH$2434.79—
OK$2534.68—
OR$2283.45—
PA$2054.23—
PR$2093.90—
RI$2738.97—
SC$2336.55—
SD$2054.23—
TN$2336.55—
TX$2534.68—
UT$2054.23—
VA$2054.23—
VI$2054.23—
VT$2738.97—
WA$2283.45—
WI$2434.79—
WV$2054.23—
WY$2054.23—
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 L1710 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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