MyMedi-AI

L2232 — Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only

HCPCS Level II L-code · short descriptor: “Rocker bottom, contact afo”

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.

L2232 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable: $119.38 in all listed states.

Former-CBA payment limits: ceiling $143.26 · floor $107.44

StateNon-ruralRural
AK$119.38—
AL$119.38—
AR$119.38—
AZ$119.38—
CA$119.38—
CO$119.38—
CT$119.38—
DC$119.38—
DE$119.38—
FL$119.38—
GA$119.38—
HI$119.38—
IA$119.38—
ID$119.38—
IL$119.38—
IN$119.38—
KS$119.38—
KY$119.38—
LA$119.38—
MA$119.38—
MD$119.38—
ME$119.38—
MI$119.38—
MN$119.38—
MO$119.38—
MS$119.38—
MT$119.38—
NC$119.38—
ND$119.38—
NE$119.38—
NH$119.38—
NJ$119.38—
NM$119.38—
NV$119.38—
NY$119.38—
OH$119.38—
OK$119.38—
OR$119.38—
PA$119.38—
PR$119.38—
RI$119.38—
SC$119.38—
SD$119.38—
TN$119.38—
TX$119.38—
UT$119.38—
VA$119.38—
VI$119.38—
VT$119.38—
WA$119.38—
WI$119.38—
WV$119.38—
WY$119.38—
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 L2232 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

Bill L2232 with confidence

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