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L2526 — Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted

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

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.

L2526 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $787.09 to $2284.23 depending on state and rural status.

Former-CBA payment limits: ceiling $1049.45 · floor $787.09

StateNon-ruralRural
AK$968.07
AL$978.93
AR$787.09
AZ$973.17
CA$973.17
CO$1019.52
CT$1014.97
DC$851.02
DE$851.02
FL$978.93
GA$978.93
HI$1035.18
IA$787.09
ID$1049.45
IL$787.09
IN$787.09
KS$787.09
KY$978.93
LA$787.09
MA$1014.97
MD$851.02
ME$1014.97
MI$787.09
MN$787.09
MO$787.09
MS$978.93
MT$1019.52
NC$978.93
ND$1019.52
NE$787.09
NH$1014.97
NJ$787.09
NM$787.09
NV$973.17
NY$787.09
OH$787.09
OK$787.09
OR$1049.45
PA$851.02
PR$2284.23
RI$1014.97
SC$978.93
SD$1019.52
TN$978.93
TX$787.09
UT$1019.52
VA$851.02
VI$787.09
VT$1014.97
WA$1049.45
WI$787.09
WV$851.02
WY$1019.52
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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