MyMedi-AI

L2320 — Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only

HCPCS Level II L-code · short descriptor: “Non-molded lacer”

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.

L2320 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $236.44 to $325.94 depending on state and rural status.

Former-CBA payment limits: ceiling $315.25 · floor $236.44

StateNon-ruralRural
AK$304.90—
AL$236.44—
AR$257.98—
AZ$315.25—
CA$315.25—
CO$301.72—
CT$289.82—
DC$236.44—
DE$236.44—
FL$236.44—
GA$236.44—
HI$325.94—
IA$252.78—
ID$302.05—
IL$237.08—
IN$237.08—
KS$252.78—
KY$236.44—
LA$257.98—
MA$289.82—
MD$236.44—
ME$289.82—
MI$237.08—
MN$237.08—
MO$252.78—
MS$236.44—
MT$301.72—
NC$236.44—
ND$301.72—
NE$252.78—
NH$289.82—
NJ$283.00—
NM$257.98—
NV$315.25—
NY$283.00—
OH$237.08—
OK$257.98—
OR$302.05—
PA$236.44—
PR$255.56—
RI$289.82—
SC$236.44—
SD$301.72—
TN$236.44—
TX$257.98—
UT$301.72—
VA$236.44—
VI$283.00—
VT$289.82—
WA$302.05—
WI$237.08—
WV$236.44—
WY$301.72—
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 L2320 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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