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L1950 — Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated

HCPCS Level II L-code · short descriptor: “Afo spiral molded to pt plas”

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.

L1950 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $855.92 to $1328.25 depending on state and rural status.

Former-CBA payment limits: ceiling $1141.23 · floor $855.92

StateNon-ruralRural
AK$1242.12
AL$855.92
AR$858.83
AZ$1141.23
CA$1141.23
CO$926.05
CT$1095.91
DC$900.87
DE$900.87
FL$855.92
GA$855.92
HI$1328.25
IA$894.48
ID$1141.23
IL$945.14
IN$945.14
KS$894.48
KY$855.92
LA$858.83
MA$1095.91
MD$900.87
ME$1095.91
MI$945.14
MN$945.14
MO$894.48
MS$855.92
MT$926.05
NC$855.92
ND$926.05
NE$894.48
NH$1095.91
NJ$1141.23
NM$858.83
NV$1141.23
NY$1141.23
OH$945.14
OK$858.83
OR$1141.23
PA$900.87
PR$1227.04
RI$1095.91
SC$855.92
SD$926.05
TN$855.92
TX$858.83
UT$926.05
VA$900.87
VI$1141.23
VT$1095.91
WA$1141.23
WI$945.14
WV$900.87
WY$926.05
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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