MyMedi-AI

L2330 — Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only

HCPCS Level II L-code · short descriptor: “Lacer molded to patient mode”

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.

L2330 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $429.42 to $904.14 depending on state and rural status.

Former-CBA payment limits: ceiling $601.62 · floor $451.21

StateNon-ruralRural
AK$845.62—
AL$451.21—
AR$478.23—
AZ$601.62—
CA$601.62—
CO$497.33—
CT$504.92—
DC$494.92—
DE$494.92—
FL$451.21—
GA$451.21—
HI$904.14—
IA$478.22—
ID$533.84—
IL$451.21—
IN$451.21—
KS$478.22—
KY$451.21—
LA$478.23—
MA$504.92—
MD$494.92—
ME$504.92—
MI$451.21—
MN$451.21—
MO$478.22—
MS$451.21—
MT$497.33—
NC$451.21—
ND$497.33—
NE$478.22—
NH$504.92—
NJ$601.62—
NM$478.23—
NV$601.62—
NY$601.62—
OH$451.21—
OK$478.23—
OR$533.84—
PA$494.92—
PR$429.42—
RI$504.92—
SC$451.21—
SD$497.33—
TN$451.21—
TX$478.23—
UT$497.33—
VA$494.92—
VI$601.62—
VT$504.92—
WA$533.84—
WI$451.21—
WV$494.92—
WY$497.33—
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 L2330 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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