L1836 — Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Ko rigid w/o joints 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.
L1836 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $89.34 to $142.64 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $134.63 | — |
| AL | $109.20 | $137.03 |
| AR | $109.20 | $137.01 |
| AZ | $89.34 | $134.63 |
| CA | $89.34 | $134.63 |
| CO | $91.02 | $137.50 |
| CT | $105.75 | $134.63 |
| DC | $98.90 | $134.63 |
| DE | $98.90 | $134.63 |
| FL | $109.20 | $137.03 |
| GA | $109.20 | $137.03 |
| HI | $134.63 | — |
| IA | $98.54 | $136.19 |
| ID | $91.02 | $134.63 |
| IL | $100.03 | $136.58 |
| IN | $100.03 | $136.58 |
| KS | $98.54 | $136.19 |
| KY | $109.20 | $137.03 |
| LA | $109.20 | $137.01 |
| MA | $105.75 | $134.63 |
| MD | $98.90 | $134.63 |
| ME | $105.75 | $134.63 |
| MI | $100.03 | $136.58 |
| MN | $98.54 | $136.58 |
| MO | $98.54 | $136.19 |
| MS | $109.20 | $137.03 |
| MT | $91.02 | $137.50 |
| NC | $109.20 | $137.03 |
| ND | $98.54 | $137.50 |
| NE | $98.54 | $136.19 |
| NH | $105.75 | $134.63 |
| NJ | $98.90 | $134.63 |
| NM | $89.34 | $137.01 |
| NV | $89.34 | $134.63 |
| NY | $98.90 | $134.63 |
| OH | $100.03 | $136.58 |
| OK | $89.34 | $137.01 |
| OR | $89.34 | $134.63 |
| PA | $98.90 | $134.63 |
| PR | $142.64 | — |
| RI | $105.75 | $134.63 |
| SC | $109.20 | $137.03 |
| SD | $98.54 | $137.50 |
| TN | $109.20 | $137.03 |
| TX | $89.34 | $137.01 |
| UT | $91.02 | $137.50 |
| VA | $109.20 | $134.63 |
| VI | $142.64 | — |
| VT | $105.75 | $134.63 |
| WA | $89.34 | $134.63 |
| WI | $100.03 | $136.58 |
| WV | $109.20 | $134.63 |
| WY | $91.02 | $137.50 |
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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