L4010 — Replace trilateral socket brim
HCPCS Level II L-code · short descriptor: “Replace trilateral socket br”
- 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.
L4010 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $771.19 to $1290.07 depending on state and rural status.
Former-CBA payment limits: ceiling $1028.26 · floor $771.19
| State | Non-rural | Rural |
|---|---|---|
| AK | $1206.45 | — |
| AL | $843.58 | — |
| AR | $791.32 | — |
| AZ | $1028.26 | — |
| CA | $1028.26 | — |
| CO | $835.97 | — |
| CT | $771.19 | — |
| DC | $771.19 | — |
| DE | $771.19 | — |
| FL | $843.58 | — |
| GA | $843.58 | — |
| HI | $1290.07 | — |
| IA | $863.92 | — |
| ID | $919.71 | — |
| IL | $987.07 | — |
| IN | $987.07 | — |
| KS | $863.92 | — |
| KY | $843.58 | — |
| LA | $791.32 | — |
| MA | $771.19 | — |
| MD | $771.19 | — |
| ME | $771.19 | — |
| MI | $987.07 | — |
| MN | $987.07 | — |
| MO | $863.92 | — |
| MS | $843.58 | — |
| MT | $835.97 | — |
| NC | $843.58 | — |
| ND | $835.97 | — |
| NE | $863.92 | — |
| NH | $771.19 | — |
| NJ | $909.40 | — |
| NM | $791.32 | — |
| NV | $1028.26 | — |
| NY | $909.40 | — |
| OH | $987.07 | — |
| OK | $791.32 | — |
| OR | $919.71 | — |
| PA | $771.19 | — |
| PR | $1142.13 | — |
| RI | $771.19 | — |
| SC | $843.58 | — |
| SD | $835.97 | — |
| TN | $843.58 | — |
| TX | $791.32 | — |
| UT | $835.97 | — |
| VA | $771.19 | — |
| VI | $909.40 | — |
| VT | $771.19 | — |
| WA | $919.71 | — |
| WI | $987.07 | — |
| WV | $771.19 | — |
| WY | $835.97 | — |
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
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