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L1834 — Knee orthosis, without knee joint, rigid, custom fabricated

HCPCS Level II L-code · short descriptor: “Ko w/0 joint rigid molded to”

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.

L1834 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $892.02 to $1808.36 depending on state and rural status.

Former-CBA payment limits: ceiling $1189.36 · floor $892.02

StateNon-ruralRural
AK$1150.92
AL$1095.91
AR$892.02
AZ$1124.13
CA$1124.13
CO$942.28
CT$1189.36
DC$892.02
DE$892.02
FL$1095.91
GA$1095.91
HI$1230.72
IA$963.36
ID$892.02
IL$892.02
IN$892.02
KS$963.36
KY$1095.91
LA$892.02
MA$1189.36
MD$892.02
ME$1189.36
MI$892.02
MN$892.02
MO$963.36
MS$1095.91
MT$942.28
NC$1095.91
ND$942.28
NE$963.36
NH$1189.36
NJ$1009.91
NM$892.02
NV$1124.13
NY$1009.91
OH$892.02
OK$892.02
OR$892.02
PA$892.02
PR$1808.36
RI$1189.36
SC$1095.91
SD$942.28
TN$1095.91
TX$892.02
UT$942.28
VA$892.02
VI$1009.92
VT$1189.36
WA$892.02
WI$892.02
WV$892.02
WY$942.28
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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