MyMedi-AI

L2182 — Addition to lower extremity fracture orthosis, drop lock knee joint

HCPCS Level II L-code · short descriptor: “Drop lock knee”

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
2
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.

L2182 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $47.61 to $140.43 depending on state and rural status.

Former-CBA payment limits: ceiling $140.43 · floor $105.33

StateNon-ruralRural
AK$122.59—
AL$105.33—
AR$131.81—
AZ$122.83—
CA$122.83—
CO$112.15—
CT$140.38—
DC$114.21—
DE$114.21—
FL$105.33—
GA$105.33—
HI$131.04—
IA$126.37—
ID$123.83—
IL$140.43—
IN$140.43—
KS$126.37—
KY$105.33—
LA$131.81—
MA$140.38—
MD$114.21—
ME$140.38—
MI$140.43—
MN$140.43—
MO$126.37—
MS$105.33—
MT$112.15—
NC$105.33—
ND$112.15—
NE$126.37—
NH$140.38—
NJ$105.33—
NM$131.81—
NV$122.83—
NY$105.33—
OH$140.43—
OK$131.81—
OR$123.83—
PA$114.21—
PR$47.61—
RI$140.38—
SC$105.33—
SD$112.15—
TN$105.33—
TX$131.81—
UT$112.15—
VA$114.21—
VI$105.33—
VT$140.38—
WA$123.83—
WI$140.43—
WV$114.21—
WY$112.15—
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 L2182 at 2 units 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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