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L2106 — Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated

HCPCS Level II L-code · short descriptor: “Afo tib fx cast plaster mold”

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.

L2106 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $781.31 to $1468.06 depending on state and rural status.

Former-CBA payment limits: ceiling $1041.75 · floor $781.31

StateNon-ruralRural
AK$1372.94
AL$781.31
AR$961.61
AZ$1041.75
CA$1041.75
CO$781.31
CT$1041.75
DC$781.31
DE$781.31
FL$781.31
GA$781.31
HI$1468.06
IA$781.31
ID$805.35
IL$968.68
IN$968.68
KS$781.31
KY$781.31
LA$961.61
MA$1041.75
MD$781.31
ME$1041.75
MI$968.68
MN$968.68
MO$781.31
MS$781.31
MT$781.31
NC$781.31
ND$781.31
NE$781.31
NH$1041.75
NJ$1002.44
NM$961.61
NV$1041.75
NY$1002.44
OH$968.68
OK$961.61
OR$805.35
PA$781.31
PR$907.97
RI$1041.75
SC$781.31
SD$781.31
TN$781.31
TX$961.61
UT$781.31
VA$781.31
VI$1002.44
VT$1041.75
WA$805.35
WI$968.68
WV$781.31
WY$781.31
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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