MyMedi-AI

L2530 — Addition to lower extremity, thigh-weight bearing, lacer, non-molded

HCPCS Level II L-code · short descriptor: “Thigh/wght bear lacer non-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
Face-to-face & WOPD
Not on the required list
MUE unit limit
2
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 2026-10-26; 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 2026-10-26; 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.

L2530 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $269.99 to $550.35 depending on state and rural status.

Former-CBA payment limits: ceiling $359.99 · floor $269.99

StateNon-ruralRural
AK$514.70—
AL$269.99—
AR$272.20—
AZ$359.99—
CA$359.99—
CO$359.99—
CT$306.22—
DC$269.99—
DE$269.99—
FL$269.99—
GA$269.99—
HI$550.35—
IA$296.76—
ID$281.90—
IL$294.73—
IN$294.73—
KS$296.76—
KY$269.99—
LA$272.20—
MA$306.22—
MD$269.99—
ME$306.22—
MI$294.73—
MN$294.73—
MO$296.76—
MS$269.99—
MT$359.99—
NC$269.99—
ND$359.99—
NE$296.76—
NH$306.22—
NJ$351.83—
NM$272.20—
NV$359.99—
NY$351.83—
OH$294.73—
OK$272.20—
OR$281.90—
PA$269.99—
PR$357.88—
RI$306.22—
SC$269.99—
SD$359.99—
TN$269.99—
TX$272.20—
UT$359.99—
VA$269.99—
VI$351.84—
VT$306.22—
WA$281.90—
WI$294.73—
WV$269.99—
WY$359.99—
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 L2530 at 2 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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