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L2525 — Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model

HCPCS Level II L-code · short descriptor: “Th/wght bear nar m-l brim mo”

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.

L2525 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1400.77 to $1889.47 depending on state and rural status.

Former-CBA payment limits: ceiling $1867.69 · floor $1400.77

StateNon-ruralRural
AK$1766.99
AL$1816.17
AR$1400.77
AZ$1743.48
CA$1743.48
CO$1574.97
CT$1867.69
DC$1491.28
DE$1491.28
FL$1816.17
GA$1816.17
HI$1889.47
IA$1534.58
ID$1491.12
IL$1400.77
IN$1400.77
KS$1534.58
KY$1816.17
LA$1400.77
MA$1867.69
MD$1491.28
ME$1867.69
MI$1400.77
MN$1400.77
MO$1534.58
MS$1816.17
MT$1574.97
NC$1816.17
ND$1574.97
NE$1534.58
NH$1867.69
NJ$1612.22
NM$1400.77
NV$1743.48
NY$1612.22
OH$1400.77
OK$1400.77
OR$1491.12
PA$1491.28
PR$1612.11
RI$1867.69
SC$1816.17
SD$1574.97
TN$1816.17
TX$1400.77
UT$1574.97
VA$1491.28
VI$1612.22
VT$1867.69
WA$1491.12
WI$1400.77
WV$1491.28
WY$1574.97
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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