MyMedi-AI

L2570 — Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each

HCPCS Level II L-code · short descriptor: “Hip clevis type 2 posit jnt”

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 2026-10-25; 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 2026-10-25; 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.

L2570 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $511.24 to $1207.51 depending on state and rural status.

Former-CBA payment limits: ceiling $729.78 · floor $547.34

StateNon-ruralRural
AK$1129.23—
AL$729.78—
AR$729.78—
AZ$729.78—
CA$729.78—
CO$547.34—
CT$547.34—
DC$547.34—
DE$547.34—
FL$729.78—
GA$729.78—
HI$1207.51—
IA$629.71—
ID$563.84—
IL$547.34—
IN$547.34—
KS$629.71—
KY$729.78—
LA$729.78—
MA$547.34—
MD$547.34—
ME$547.34—
MI$547.34—
MN$547.34—
MO$629.71—
MS$729.78—
MT$547.34—
NC$729.78—
ND$547.34—
NE$629.71—
NH$547.34—
NJ$547.34—
NM$729.78—
NV$729.78—
NY$547.34—
OH$547.34—
OK$729.78—
OR$563.84—
PA$547.34—
PR$511.24—
RI$547.34—
SC$729.78—
SD$547.34—
TN$729.78—
TX$729.78—
UT$547.34—
VA$547.34—
VI$547.34—
VT$547.34—
WA$563.84—
WI$547.34—
WV$547.34—
WY$547.34—
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 L2570 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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