MyMedi-AI

L2492 — Addition to knee joint, lift loop for drop lock ring

HCPCS Level II L-code · short descriptor: “Knee lift loop drop lock rin”

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.

L2492 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $117.18 to $156.11 depending on state and rural status.

Former-CBA payment limits: ceiling $156.24 · floor $117.18

StateNon-ruralRural
AK$140.32—
AL$117.18—
AR$130.79—
AZ$135.86—
CA$135.86—
CO$146.73—
CT$136.32—
DC$156.11—
DE$156.11—
FL$117.18—
GA$117.18—
HI$150.04—
IA$117.18—
ID$121.49—
IL$144.15—
IN$144.15—
KS$117.18—
KY$117.18—
LA$130.79—
MA$136.32—
MD$156.11—
ME$136.32—
MI$144.15—
MN$144.15—
MO$117.18—
MS$117.18—
MT$146.73—
NC$117.18—
ND$146.73—
NE$117.18—
NH$136.32—
NJ$133.49—
NM$130.79—
NV$135.86—
NY$133.49—
OH$144.15—
OK$130.79—
OR$121.49—
PA$156.11—
PR$123.72—
RI$136.32—
SC$117.18—
SD$146.73—
TN$117.18—
TX$130.79—
UT$146.73—
VA$156.11—
VI$133.52—
VT$136.32—
WA$121.49—
WI$144.15—
WV$156.11—
WY$146.73—
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 L2492 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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