MyMedi-AI

L2415 — Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint

HCPCS Level II L-code · short descriptor: “Knee joint cam lock each joi”

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
4
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.

L2415 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $145.69 to $160.30 depending on state and rural status.

Former-CBA payment limits: ceiling $177.82 · floor $133.36

StateNon-ruralRural
AK$145.69—
AL$150.10—
AR$150.07—
AZ$145.69—
CA$145.69—
CO$150.98—
CT$145.69—
DC$145.69—
DE$145.69—
FL$150.10—
GA$150.10—
HI$145.69—
IA$148.55—
ID$145.69—
IL$149.30—
IN$149.30—
KS$148.55—
KY$150.10—
LA$150.07—
MA$145.69—
MD$145.69—
ME$145.69—
MI$149.30—
MN$149.30—
MO$148.55—
MS$150.10—
MT$150.98—
NC$150.10—
ND$150.98—
NE$148.55—
NH$145.69—
NJ$145.69—
NM$150.07—
NV$145.69—
NY$145.69—
OH$149.30—
OK$150.07—
OR$145.69—
PA$145.69—
PR$160.30—
RI$145.69—
SC$150.10—
SD$150.98—
TN$150.10—
TX$150.07—
UT$150.98—
VA$145.69—
VI$160.30—
VT$145.69—
WA$145.69—
WI$149.30—
WV$145.69—
WY$150.98—
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 L2415 at 4 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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