MyMedi-AI

L2136 — Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment

HCPCS Level II L-code · short descriptor: “Kafo femoral fx cast 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.

L2136 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1358.95 to $2855.32 depending on state and rural status.

Former-CBA payment limits: ceiling $1811.94 · floor $1358.95

StateNon-ruralRural
AK$2106.89
AL$1358.95
AR$1480.79
AZ$1811.94
CA$1811.94
CO$1527.44
CT$1527.32
DC$1477.06
DE$1477.06
FL$1358.95
GA$1358.95
HI$2252.88
IA$1372.09
ID$1358.95
IL$1549.86
IN$1549.86
KS$1372.09
KY$1358.95
LA$1480.79
MA$1527.32
MD$1477.06
ME$1527.32
MI$1549.86
MN$1549.86
MO$1372.09
MS$1358.95
MT$1527.44
NC$1358.95
ND$1527.44
NE$1372.09
NH$1527.32
NJ$1811.94
NM$1480.79
NV$1811.94
NY$1811.94
OH$1549.86
OK$1480.79
OR$1358.95
PA$1477.06
PR$2855.32
RI$1527.32
SC$1358.95
SD$1527.44
TN$1358.95
TX$1480.79
UT$1527.44
VA$1477.06
VI$1811.94
VT$1527.32
WA$1358.95
WI$1549.86
WV$1477.06
WY$1527.44
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

Bill L2136 with confidence

MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →