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L2500 — Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring

HCPCS Level II L-code · short descriptor: “Thi/glut/ischia wgt bearing”

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
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

L2500 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $225.00 to $563.67 depending on state and rural status.

Former-CBA payment limits: ceiling $483.36 · floor $362.52

StateNon-ruralRural
AK$527.17
AL$362.52
AR$422.73
AZ$483.36
CA$483.36
CO$362.52
CT$483.36
DC$373.46
DE$373.46
FL$362.52
GA$362.52
HI$563.67
IA$363.38
ID$389.21
IL$384.58
IN$384.58
KS$363.38
KY$362.52
LA$422.73
MA$483.36
MD$373.46
ME$483.36
MI$384.58
MN$384.58
MO$363.38
MS$362.52
MT$362.52
NC$362.52
ND$362.52
NE$363.38
NH$483.36
NJ$362.52
NM$422.73
NV$483.36
NY$362.52
OH$384.58
OK$422.73
OR$389.21
PA$373.46
PR$225.00
RI$483.36
SC$362.52
SD$362.52
TN$362.52
TX$422.73
UT$362.52
VA$373.46
VI$362.52
VT$483.36
WA$389.21
WI$384.58
WV$373.46
WY$362.52
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. 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.

Common denial codes to watch

Related L-codes

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