L2800 — Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only
HCPCS Level II L-code · short descriptor: “Knee cap medial or lateral p”
- 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
- 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.
L2800 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $104.71 to $215.66 depending on state and rural status.
Former-CBA payment limits: ceiling $163.43 · floor $122.57
| State | Non-rural | Rural |
|---|---|---|
| AK | $201.67 | — |
| AL | $122.57 | — |
| AR | $122.57 | — |
| AZ | $163.43 | — |
| CA | $163.43 | — |
| CO | $134.44 | — |
| CT | $163.43 | — |
| DC | $152.45 | — |
| DE | $152.45 | — |
| FL | $122.57 | — |
| GA | $122.57 | — |
| HI | $215.66 | — |
| IA | $122.57 | — |
| ID | $140.51 | — |
| IL | $123.76 | — |
| IN | $123.76 | — |
| KS | $122.57 | — |
| KY | $122.57 | — |
| LA | $122.57 | — |
| MA | $163.43 | — |
| MD | $152.45 | — |
| ME | $163.43 | — |
| MI | $123.76 | — |
| MN | $123.76 | — |
| MO | $122.57 | — |
| MS | $122.57 | — |
| MT | $134.44 | — |
| NC | $122.57 | — |
| ND | $134.44 | — |
| NE | $122.57 | — |
| NH | $163.43 | — |
| NJ | $122.57 | — |
| NM | $122.57 | — |
| NV | $163.43 | — |
| NY | $122.57 | — |
| OH | $123.76 | — |
| OK | $122.57 | — |
| OR | $140.51 | — |
| PA | $152.45 | — |
| PR | $104.71 | — |
| RI | $163.43 | — |
| SC | $122.57 | — |
| SD | $134.44 | — |
| TN | $122.57 | — |
| TX | $122.57 | — |
| UT | $134.44 | — |
| VA | $152.45 | — |
| VI | $122.57 | — |
| VT | $163.43 | — |
| WA | $140.51 | — |
| WI | $123.76 | — |
| WV | $152.45 | — |
| WY | $134.44 | — |
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
Bill L2800 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →