L1830 — Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Ko immob canvas long pre ots”
- 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.
L1830 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $63.18 to $149.93 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $142.71 | — |
| AL | $77.23 | $100.93 |
| AR | $77.23 | $88.88 |
| AZ | $63.18 | $105.63 |
| CA | $63.18 | $105.63 |
| CO | $64.38 | $91.69 |
| CT | $74.79 | $88.88 |
| DC | $69.94 | $91.93 |
| DE | $69.94 | $91.93 |
| FL | $77.23 | $100.93 |
| GA | $77.23 | $100.93 |
| HI | $149.93 | — |
| IA | $69.69 | $90.97 |
| ID | $64.38 | $102.85 |
| IL | $70.75 | $89.73 |
| IN | $70.75 | $89.73 |
| KS | $69.69 | $90.97 |
| KY | $77.23 | $100.93 |
| LA | $77.23 | $88.88 |
| MA | $74.79 | $88.88 |
| MD | $69.94 | $91.93 |
| ME | $74.79 | $88.88 |
| MI | $70.75 | $89.73 |
| MN | $69.69 | $89.73 |
| MO | $69.69 | $90.97 |
| MS | $77.23 | $100.93 |
| MT | $64.38 | $91.69 |
| NC | $77.23 | $100.93 |
| ND | $69.69 | $91.69 |
| NE | $69.69 | $90.97 |
| NH | $74.79 | $88.88 |
| NJ | $69.94 | $98.20 |
| NM | $63.18 | $88.88 |
| NV | $63.18 | $105.63 |
| NY | $69.94 | $98.20 |
| OH | $70.75 | $89.73 |
| OK | $63.18 | $88.88 |
| OR | $63.18 | $102.85 |
| PA | $69.94 | $91.93 |
| PR | $102.48 | — |
| RI | $74.79 | $88.88 |
| SC | $77.23 | $100.93 |
| SD | $69.69 | $91.69 |
| TN | $77.23 | $100.93 |
| TX | $63.18 | $88.88 |
| UT | $64.38 | $91.69 |
| VA | $77.23 | $91.93 |
| VI | $98.20 | — |
| VT | $74.79 | $88.88 |
| WA | $63.18 | $102.85 |
| WI | $70.75 | $89.73 |
| WV | $77.23 | $91.93 |
| WY | $64.38 | $91.69 |
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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