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L2038 — Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated

HCPCS Level II L-code · short descriptor: “Kafo w/o joint multi-axis an”

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.

L2038 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1642.94 to $2190.58 depending on state and rural status.

Former-CBA payment limits: ceiling $2190.58 · floor $1642.94

StateNon-ruralRural
AK$1811.70
AL$1642.94
AR$1642.94
AZ$1875.31
CA$1875.31
CO$1642.94
CT$2190.58
DC$2093.86
DE$2093.86
FL$1642.94
GA$1642.94
HI$1937.29
IA$1642.94
ID$1911.46
IL$1642.94
IN$1642.94
KS$1642.94
KY$1642.94
LA$1642.94
MA$2190.58
MD$2093.86
ME$2190.58
MI$1642.94
MN$1642.94
MO$1642.94
MS$1642.94
MT$1642.94
NC$1642.94
ND$1642.94
NE$1642.94
NH$2190.58
NJ$2158.33
NM$1642.94
NV$1875.31
NY$2158.33
OH$1642.94
OK$1642.94
OR$1911.46
PA$2093.86
PR$2093.90
RI$2190.58
SC$1642.94
SD$1642.94
TN$1642.94
TX$1642.94
UT$1642.94
VA$2093.86
VI$2158.33
VT$2190.58
WA$1911.46
WI$1642.94
WV$2093.86
WY$1642.94
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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