L1850 — Knee orthosis, swedish type, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Ko swedish type 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.
L1850 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $205.78 to $408.53 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $390.22 | — |
| AL | $251.50 | $291.13 |
| AR | $251.50 | $317.00 |
| AZ | $205.78 | $346.26 |
| CA | $205.78 | $346.26 |
| CO | $209.64 | $314.10 |
| CT | $243.56 | $329.15 |
| DC | $227.80 | $300.40 |
| DE | $227.80 | $300.40 |
| FL | $251.50 | $291.13 |
| GA | $251.50 | $291.13 |
| HI | $408.53 | — |
| IA | $226.96 | $297.17 |
| ID | $209.64 | $310.43 |
| IL | $230.40 | $300.81 |
| IN | $230.40 | $300.81 |
| KS | $226.96 | $297.17 |
| KY | $251.50 | $291.13 |
| LA | $251.50 | $317.00 |
| MA | $243.56 | $329.15 |
| MD | $227.80 | $300.40 |
| ME | $243.56 | $329.15 |
| MI | $230.40 | $300.81 |
| MN | $226.96 | $300.81 |
| MO | $226.96 | $297.17 |
| MS | $251.50 | $291.13 |
| MT | $209.64 | $314.10 |
| NC | $251.50 | $291.13 |
| ND | $226.96 | $314.10 |
| NE | $226.96 | $297.17 |
| NH | $243.56 | $329.15 |
| NJ | $227.80 | $307.36 |
| NM | $205.78 | $317.00 |
| NV | $205.78 | $346.26 |
| NY | $227.80 | $307.36 |
| OH | $230.40 | $300.81 |
| OK | $205.78 | $317.00 |
| OR | $205.78 | $310.43 |
| PA | $227.80 | $300.40 |
| PR | $363.69 | — |
| RI | $243.56 | $329.15 |
| SC | $251.50 | $291.13 |
| SD | $226.96 | $314.10 |
| TN | $251.50 | $291.13 |
| TX | $205.78 | $317.00 |
| UT | $209.64 | $314.10 |
| VA | $251.50 | $300.40 |
| VI | $307.36 | — |
| VT | $243.56 | $329.15 |
| WA | $205.78 | $310.43 |
| WI | $230.40 | $300.81 |
| WV | $251.50 | $300.40 |
| WY | $209.64 | $314.10 |
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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