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L5060 — Ankle, symes, metal frame, molded leather socket, articulated ankle/foot

HCPCS Level II L-code · short descriptor: “Symes met fr leath socket ar”

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.

L5060 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1022.60 to $4748.30 depending on state and rural status.

Former-CBA payment limits: ceiling $4508.51 · floor $3381.38

StateNon-ruralRural
AK$4440.57
AL$3381.38
AR$4001.69
AZ$4508.51
CA$4508.51
CO$4131.18
CT$3381.38
DC$3381.38
DE$3381.38
FL$3381.38
GA$3381.38
HI$4748.30
IA$3731.60
ID$4379.14
IL$4159.16
IN$4159.16
KS$3731.60
KY$3381.38
LA$4001.69
MA$3381.38
MD$3381.38
ME$3381.38
MI$4159.16
MN$4159.16
MO$3731.60
MS$3381.38
MT$4131.18
NC$3381.38
ND$4131.18
NE$3731.60
NH$3381.38
NJ$4508.51
NM$4001.69
NV$4508.51
NY$4508.51
OH$4159.16
OK$4001.69
OR$4379.14
PA$3381.38
PR$1022.60
RI$3381.38
SC$3381.38
SD$4131.18
TN$3381.38
TX$4001.69
UT$4131.18
VA$3381.38
VI$4508.51
VT$3381.38
WA$4379.14
WI$4159.16
WV$3381.38
WY$4131.18
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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