MyMedi-AI

L2080 — Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated

HCPCS Level II L-code · short descriptor: “Hkafo unilat torsion cable”

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
Face-to-face & WOPD
Not on the required list
MUE unit limit
1
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L2080 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $413.32 to $662.26 depending on state and rural status.

Former-CBA payment limits: ceiling $551.09 · floor $413.32

StateNon-ruralRural
AK$619.27—
AL$439.45—
AR$441.61—
AZ$551.09—
CA$551.09—
CO$413.32—
CT$551.09—
DC$413.32—
DE$413.32—
FL$439.45—
GA$439.45—
HI$662.26—
IA$449.17—
ID$476.47—
IL$458.63—
IN$458.63—
KS$449.17—
KY$439.45—
LA$441.61—
MA$551.09—
MD$413.32—
ME$551.09—
MI$458.63—
MN$458.63—
MO$449.17—
MS$439.45—
MT$413.32—
NC$439.45—
ND$413.32—
NE$449.17—
NH$551.09—
NJ$438.56—
NM$441.61—
NV$551.09—
NY$438.56—
OH$458.63—
OK$441.61—
OR$476.47—
PA$413.32—
PR$523.52—
RI$551.09—
SC$439.45—
SD$413.32—
TN$439.45—
TX$441.61—
UT$413.32—
VA$413.32—
VI$438.56—
VT$551.09—
WA$476.47—
WI$458.63—
WV$413.32—
WY$413.32—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L2080 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

Related L-codes

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