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L2037 — Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated

HCPCS Level II L-code · short descriptor: “Kafo plas sing 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.

L2037 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1913.97 to $2959.04 depending on state and rural status.

Former-CBA payment limits: ceiling $2551.96 · floor $1913.97

StateNon-ruralRural
AK$2633.45
AL$1964.76
AR$1913.97
AZ$2551.96
CA$2551.96
CO$1913.97
CT$2551.96
DC$2061.21
DE$2061.21
FL$1964.76
GA$1964.76
HI$2816.02
IA$1913.97
ID$2269.05
IL$2038.02
IN$2038.02
KS$1913.97
KY$1964.76
LA$1913.97
MA$2551.96
MD$2061.21
ME$2551.96
MI$2038.02
MN$2038.02
MO$1913.97
MS$1964.76
MT$1913.97
NC$1964.76
ND$1913.97
NE$1913.97
NH$2551.96
NJ$2515.30
NM$1913.97
NV$2551.96
NY$2515.30
OH$2038.02
OK$1913.97
OR$2269.05
PA$2061.21
PR$2959.04
RI$2551.96
SC$1964.76
SD$1913.97
TN$1964.76
TX$1913.97
UT$1913.97
VA$2061.21
VI$2515.29
VT$2551.96
WA$2269.05
WI$2038.02
WV$2061.21
WY$1913.97
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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