MyMedi-AI

L2520 — Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted

HCPCS Level II L-code · short descriptor: “Th/wght bear quad-lat brim c”

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
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.

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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L2520 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $529.38 to $856.60 depending on state and rural status.

Former-CBA payment limits: ceiling $705.84 · floor $529.38

StateNon-ruralRural
AK$713.42
AL$529.38
AR$605.28
AZ$705.84
CA$705.84
CO$566.56
CT$684.73
DC$552.74
DE$552.74
FL$529.38
GA$529.38
HI$762.91
IA$529.38
ID$559.39
IL$660.58
IN$660.58
KS$529.38
KY$529.38
LA$605.28
MA$684.73
MD$552.74
ME$684.73
MI$660.58
MN$660.58
MO$529.38
MS$529.38
MT$566.56
NC$529.38
ND$566.56
NE$529.38
NH$684.73
NJ$652.24
NM$605.28
NV$705.84
NY$652.24
OH$660.58
OK$605.28
OR$559.39
PA$552.74
PR$856.60
RI$684.73
SC$529.38
SD$566.56
TN$529.38
TX$605.28
UT$566.56
VA$552.74
VI$652.23
VT$684.73
WA$559.39
WI$660.58
WV$552.74
WY$566.56
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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