L5100 — Below knee, molded socket, shin, sach foot
HCPCS Level II L-code · short descriptor: “Molded socket shin sach foot”
- 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.
L5100 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $2845.34 to $3807.08 depending on state and rural status.
Former-CBA payment limits: ceiling $3793.78 · floor $2845.34
| State | Non-rural | Rural |
|---|---|---|
| AK | $3178.64 | — |
| AL | $2946.06 | — |
| AR | $3480.09 | — |
| AZ | $3291.35 | — |
| CA | $3291.35 | — |
| CO | $2845.34 | — |
| CT | $3420.07 | — |
| DC | $2926.84 | — |
| DE | $2926.84 | — |
| FL | $2946.06 | — |
| GA | $2946.06 | — |
| HI | $3398.88 | — |
| IA | $3224.52 | — |
| ID | $3420.57 | — |
| IL | $3359.56 | — |
| IN | $3359.56 | — |
| KS | $3224.52 | — |
| KY | $2946.06 | — |
| LA | $3480.09 | — |
| MA | $3420.07 | — |
| MD | $2926.84 | — |
| ME | $3420.07 | — |
| MI | $3359.56 | — |
| MN | $3359.56 | — |
| MO | $3224.52 | — |
| MS | $2946.06 | — |
| MT | $2845.34 | — |
| NC | $2946.06 | — |
| ND | $2845.34 | — |
| NE | $3224.52 | — |
| NH | $3420.07 | — |
| NJ | $3102.74 | — |
| NM | $3480.09 | — |
| NV | $3291.35 | — |
| NY | $3102.74 | — |
| OH | $3359.56 | — |
| OK | $3480.09 | — |
| OR | $3420.57 | — |
| PA | $2926.84 | — |
| PR | $3807.08 | — |
| RI | $3420.07 | — |
| SC | $2946.06 | — |
| SD | $2845.34 | — |
| TN | $2946.06 | — |
| TX | $3480.09 | — |
| UT | $2845.34 | — |
| VA | $2926.84 | — |
| VI | $3102.74 | — |
| VT | $3420.07 | — |
| WA | $3420.57 | — |
| WI | $3359.56 | — |
| WV | $2926.84 | — |
| WY | $2845.34 | — |
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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