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L5050 — Ankle, symes, molded socket, sach foot

HCPCS Level II L-code · short descriptor: “Ank symes mold sckt sach ft”

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.

L5050 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $2809.59 to $3807.08 depending on state and rural status.

Former-CBA payment limits: ceiling $3746.12 · floor $2809.59

StateNon-ruralRural
AK$3244.62
AL$2939.57
AR$3541.48
AZ$3259.73
CA$3259.73
CO$3047.90
CT$3335.31
DC$2809.59
DE$2809.59
FL$2939.57
GA$2939.57
HI$3469.47
IA$2832.25
ID$3300.11
IL$3374.00
IN$3374.00
KS$2832.25
KY$2939.57
LA$3541.48
MA$3335.31
MD$2809.59
ME$3335.31
MI$3374.00
MN$3374.00
MO$2832.25
MS$2939.57
MT$3047.90
NC$2939.57
ND$3047.90
NE$2832.25
NH$3335.31
NJ$2994.80
NM$3541.48
NV$3259.73
NY$2994.80
OH$3374.00
OK$3541.48
OR$3300.11
PA$2809.59
PR$3807.08
RI$3335.31
SC$2939.57
SD$3047.90
TN$2939.57
TX$3541.48
UT$3047.90
VA$2809.59
VI$2994.77
VT$3335.31
WA$3300.11
WI$3374.00
WV$2809.59
WY$3047.90
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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