L1833 — Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf
HCPCS Level II L-code · short descriptor: “Ko adj jnt pos r sup 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
- Face-to-face & WOPD
- Not on the required 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.
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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.
Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.
L1833 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $455.16 to $1087.16 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $685.69 | — |
| AL | $556.31 | $743.90 |
| AR | $556.31 | $627.47 |
| AZ | $455.16 | $695.27 |
| CA | $455.16 | $695.27 |
| CO | $463.72 | $627.47 |
| CT | $538.74 | $734.24 |
| DC | $503.87 | $684.50 |
| DE | $503.87 | $684.50 |
| FL | $556.31 | $743.90 |
| GA | $556.31 | $743.90 |
| HI | $713.94 | — |
| IA | $502.02 | $627.47 |
| ID | $463.72 | $627.47 |
| IL | $509.63 | $701.41 |
| IN | $509.63 | $701.41 |
| KS | $502.02 | $627.47 |
| KY | $556.31 | $743.90 |
| LA | $556.31 | $627.47 |
| MA | $538.74 | $734.24 |
| MD | $503.87 | $684.50 |
| ME | $538.74 | $734.24 |
| MI | $509.63 | $701.41 |
| MN | $502.02 | $701.41 |
| MO | $502.02 | $627.47 |
| MS | $556.31 | $743.90 |
| MT | $463.72 | $627.47 |
| NC | $556.31 | $743.90 |
| ND | $502.02 | $627.47 |
| NE | $502.02 | $627.47 |
| NH | $538.74 | $734.24 |
| NJ | $503.87 | $743.90 |
| NM | $455.16 | $627.47 |
| NV | $455.16 | $695.27 |
| NY | $503.87 | $743.90 |
| OH | $509.63 | $701.41 |
| OK | $455.16 | $627.47 |
| OR | $455.16 | $627.47 |
| PA | $503.87 | $684.50 |
| PR | $1087.16 | — |
| RI | $538.74 | $734.24 |
| SC | $556.31 | $743.90 |
| SD | $502.02 | $627.47 |
| TN | $556.31 | $743.90 |
| TX | $455.16 | $627.47 |
| UT | $463.72 | $627.47 |
| VA | $556.31 | $684.50 |
| VI | $743.90 | — |
| VT | $538.74 | $734.24 |
| WA | $455.16 | $627.47 |
| WI | $509.63 | $701.41 |
| WV | $556.31 | $684.50 |
| WY | $463.72 | $627.47 |
Common denial codes to watch
Related L-codes
Bill L1833 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →
Building an AI agent? Try the agent API in the playground — free PA-required lookups, L1833 included, and starter credits via POST /bot-marketplace/register.