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L1930 — Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment

HCPCS Level II L-code · short descriptor: “Afo plastic”

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.

L1930 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $225.00 to $459.82 depending on state and rural status.

Former-CBA payment limits: ceiling $362.45 · floor $271.84

StateNon-ruralRural
AK$430.04
AL$271.84
AR$362.45
AZ$362.45
CA$362.45
CO$296.70
CT$313.72
DC$271.84
DE$271.84
FL$271.84
GA$271.84
HI$459.82
IA$317.73
ID$317.49
IL$309.60
IN$309.60
KS$317.73
KY$271.84
LA$362.45
MA$313.72
MD$271.84
ME$313.72
MI$309.60
MN$309.60
MO$317.73
MS$271.84
MT$296.70
NC$271.84
ND$296.70
NE$317.73
NH$313.72
NJ$271.84
NM$362.45
NV$362.45
NY$271.84
OH$309.60
OK$362.45
OR$317.49
PA$271.84
PR$225.00
RI$313.72
SC$271.84
SD$296.70
TN$271.84
TX$362.45
UT$296.70
VA$271.84
VI$271.84
VT$313.72
WA$317.49
WI$309.60
WV$271.84
WY$296.70
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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