MyMedi-AI

L2184 — Addition to lower extremity fracture orthosis, limited motion knee joint

HCPCS Level II L-code · short descriptor: “Limited motion knee joint”

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.

L2184 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $66.65 to $189.80 depending on state and rural status.

Former-CBA payment limits: ceiling $189.80 · floor $142.35

StateNon-ruralRural
AK$110.09—
AL$189.80—
AR$171.28—
AZ$142.35—
CA$142.35—
CO$155.93—
CT$147.37—
DC$156.13—
DE$156.13—
FL$189.80—
GA$189.80—
HI$117.71—
IA$142.35—
ID$142.35—
IL$142.35—
IN$142.35—
KS$142.35—
KY$189.80—
LA$171.28—
MA$147.37—
MD$156.13—
ME$147.37—
MI$142.35—
MN$142.35—
MO$142.35—
MS$189.80—
MT$155.93—
NC$189.80—
ND$155.93—
NE$142.35—
NH$147.37—
NJ$142.35—
NM$171.28—
NV$142.35—
NY$142.35—
OH$142.35—
OK$171.28—
OR$142.35—
PA$156.13—
PR$66.65—
RI$147.37—
SC$189.80—
SD$155.93—
TN$189.80—
TX$171.28—
UT$155.93—
VA$156.13—
VI$142.35—
VT$147.37—
WA$142.35—
WI$142.35—
WV$156.13—
WY$155.93—
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 L2184 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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