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L2134 — Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment

HCPCS Level II L-code · short descriptor: “Kafo fem fx cast semi-rigid”

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.

L2134 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1111.41 to $1713.20 depending on state and rural status.

Former-CBA payment limits: ceiling $1481.88 · floor $1111.41

StateNon-ruralRural
AK$1558.60
AL$1111.41
AR$1307.92
AZ$1481.88
CA$1481.88
CO$1111.41
CT$1366.42
DC$1237.52
DE$1237.52
FL$1111.41
GA$1111.41
HI$1666.67
IA$1111.41
ID$1162.25
IL$1416.24
IN$1416.24
KS$1111.41
KY$1111.41
LA$1307.92
MA$1366.42
MD$1237.52
ME$1366.42
MI$1416.24
MN$1416.24
MO$1111.41
MS$1111.41
MT$1111.41
NC$1111.41
ND$1111.41
NE$1111.41
NH$1366.42
NJ$1481.88
NM$1307.92
NV$1481.88
NY$1481.88
OH$1416.24
OK$1307.92
OR$1162.25
PA$1237.52
PR$1713.20
RI$1366.42
SC$1111.41
SD$1111.41
TN$1111.41
TX$1307.92
UT$1111.41
VA$1237.52
VI$1481.88
VT$1366.42
WA$1162.25
WI$1416.24
WV$1237.52
WY$1111.41
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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