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L1900 — Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated

HCPCS Level II L-code · short descriptor: “Afo sprng wir drsflx calf bd”

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.

L1900 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $310.01 to $398.09 depending on state and rural status.

Former-CBA payment limits: ceiling $413.34 · floor $310.01

StateNon-ruralRural
AK$347.44
AL$347.57
AR$398.09
AZ$350.66
CA$350.66
CO$338.06
CT$364.99
DC$310.01
DE$310.01
FL$347.57
GA$347.57
HI$371.47
IA$322.82
ID$341.79
IL$350.64
IN$350.64
KS$322.82
KY$347.57
LA$398.09
MA$364.99
MD$310.01
ME$364.99
MI$350.64
MN$350.64
MO$322.82
MS$347.57
MT$338.06
NC$347.57
ND$338.06
NE$322.82
NH$364.99
NJ$310.01
NM$398.09
NV$350.66
NY$310.01
OH$350.64
OK$398.09
OR$341.79
PA$310.01
PR$352.16
RI$364.99
SC$347.57
SD$338.06
TN$347.57
TX$398.09
UT$338.06
VA$310.01
VI$310.01
VT$364.99
WA$341.79
WI$350.64
WV$310.01
WY$338.06
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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