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L2036 — Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated

HCPCS Level II L-code · short descriptor: “Kafo plas doub free knee mol”

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.

L2036 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $2131.99 to $4092.63 depending on state and rural status.

Former-CBA payment limits: ceiling $2842.66 · floor $2131.99

StateNon-ruralRural
AK$2590.22
AL$2131.99
AR$2240.26
AZ$2549.08
CA$2549.08
CO$2340.32
CT$2842.66
DC$2209.36
DE$2209.36
FL$2131.99
GA$2131.99
HI$2769.78
IA$2131.99
ID$2750.39
IL$2278.43
IN$2278.43
KS$2131.99
KY$2131.99
LA$2240.26
MA$2842.66
MD$2209.36
ME$2842.66
MI$2278.43
MN$2278.43
MO$2131.99
MS$2131.99
MT$2340.32
NC$2131.99
ND$2340.32
NE$2131.99
NH$2842.66
NJ$2842.66
NM$2240.26
NV$2549.08
NY$2842.66
OH$2278.43
OK$2240.26
OR$2750.39
PA$2209.36
PR$4092.63
RI$2842.66
SC$2131.99
SD$2340.32
TN$2131.99
TX$2240.26
UT$2340.32
VA$2209.36
VI$2842.66
VT$2842.66
WA$2750.39
WI$2278.43
WV$2209.36
WY$2340.32
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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