MyMedi-AI

L2580 — Addition to lower extremity, pelvic control, pelvic sling

HCPCS Level II L-code · short descriptor: “Pelvic control pelvic sling”

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.

L2580 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $533.32 to $906.36 depending on state and rural status.

Former-CBA payment limits: ceiling $711.09 · floor $533.32

StateNon-ruralRural
AK$847.64—
AL$691.79—
AR$533.32—
AZ$711.09—
CA$711.09—
CO$697.57—
CT$595.07—
DC$533.32—
DE$533.32—
FL$691.79—
GA$691.79—
HI$906.36—
IA$533.32—
ID$630.29—
IL$533.32—
IN$533.32—
KS$533.32—
KY$691.79—
LA$533.32—
MA$595.07—
MD$533.32—
ME$595.07—
MI$533.32—
MN$533.32—
MO$533.32—
MS$691.79—
MT$697.57—
NC$691.79—
ND$697.57—
NE$533.32—
NH$595.07—
NJ$611.91—
NM$533.32—
NV$711.09—
NY$611.91—
OH$533.32—
OK$533.32—
OR$630.29—
PA$533.32—
PR$613.50—
RI$595.07—
SC$691.79—
SD$697.57—
TN$691.79—
TX$533.32—
UT$697.57—
VA$533.32—
VI$611.91—
VT$595.07—
WA$630.29—
WI$533.32—
WV$533.32—
WY$697.57—
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 L2580 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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