MyMedi-AI

L2610 — Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each

HCPCS Level II L-code · short descriptor: “Hip clevis/thrust bearing lo”

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.

L2610 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $133.09 to $587.25 depending on state and rural status.

Former-CBA payment limits: ceiling $372.09 · floor $279.07

StateNon-ruralRural
AK$549.19—
AL$279.07—
AR$372.09—
AZ$372.09—
CA$372.09—
CO$292.14—
CT$279.07—
DC$309.33—
DE$309.33—
FL$279.07—
GA$279.07—
HI$587.25—
IA$279.07—
ID$329.45—
IL$289.65—
IN$289.65—
KS$279.07—
KY$279.07—
LA$372.09—
MA$279.07—
MD$309.33—
ME$279.07—
MI$289.65—
MN$289.65—
MO$279.07—
MS$279.07—
MT$292.14—
NC$279.07—
ND$292.14—
NE$279.07—
NH$279.07—
NJ$325.67—
NM$372.09—
NV$372.09—
NY$325.67—
OH$289.65—
OK$372.09—
OR$329.45—
PA$309.33—
PR$133.09—
RI$279.07—
SC$279.07—
SD$292.14—
TN$279.07—
TX$372.09—
UT$292.14—
VA$309.33—
VI$325.67—
VT$279.07—
WA$329.45—
WI$289.65—
WV$309.33—
WY$292.14—
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 L2610 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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