MyMedi-AI

L2240 — Addition to lower extremity, round caliper and plate attachment

HCPCS Level II L-code · short descriptor: “Round caliper and plate atta”

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.

L2240 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $25.45 to $219.49 depending on state and rural status.

Former-CBA payment limits: ceiling $128.15 · floor $96.11

StateNon-ruralRural
AK$205.26—
AL$96.11—
AR$96.11—
AZ$128.15—
CA$128.15—
CO$96.11—
CT$118.25—
DC$109.14—
DE$109.14—
FL$96.11—
GA$96.11—
HI$219.49—
IA$101.28—
ID$97.01—
IL$117.01—
IN$117.01—
KS$101.28—
KY$96.11—
LA$96.11—
MA$118.25—
MD$109.14—
ME$118.25—
MI$117.01—
MN$117.01—
MO$101.28—
MS$96.11—
MT$96.11—
NC$96.11—
ND$96.11—
NE$101.28—
NH$118.25—
NJ$96.11—
NM$96.11—
NV$128.15—
NY$96.11—
OH$117.01—
OK$96.11—
OR$97.01—
PA$109.14—
PR$25.45—
RI$118.25—
SC$96.11—
SD$96.11—
TN$96.11—
TX$96.11—
UT$96.11—
VA$109.14—
VI$96.11—
VT$118.25—
WA$97.01—
WI$117.01—
WV$109.14—
WY$96.11—
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 L2240 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

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