L5301 — Below knee, molded socket, shin, sach foot, endoskeletal system
HCPCS Level II L-code · short descriptor: “Bk mold socket sach ft endo”
- 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.
L5301 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $2810.90 to $4330.82 depending on state and rural status.
Former-CBA payment limits: ceiling $3747.87 · floor $2810.90
| State | Non-rural | Rural |
|---|---|---|
| AK | $3983.69 | — |
| AL | $3367.55 | — |
| AR | $3376.36 | — |
| AZ | $3731.84 | — |
| CA | $3731.84 | — |
| CO | $2834.07 | — |
| CT | $3003.12 | — |
| DC | $2810.90 | — |
| DE | $2810.90 | — |
| FL | $3367.55 | — |
| GA | $3367.55 | — |
| HI | $4314.60 | — |
| IA | $3185.00 | — |
| ID | $3429.81 | — |
| IL | $3299.01 | — |
| IN | $3299.01 | — |
| KS | $3185.00 | — |
| KY | $3367.55 | — |
| LA | $3376.36 | — |
| MA | $3003.12 | — |
| MD | $2810.90 | — |
| ME | $3003.12 | — |
| MI | $3299.01 | — |
| MN | $3299.01 | — |
| MO | $3185.00 | — |
| MS | $3367.55 | — |
| MT | $2834.07 | — |
| NC | $3367.55 | — |
| ND | $2834.07 | — |
| NE | $3185.00 | — |
| NH | $3003.12 | — |
| NJ | $2810.90 | — |
| NM | $3376.36 | — |
| NV | $3731.84 | — |
| NY | $2810.90 | — |
| OH | $3299.01 | — |
| OK | $3376.36 | — |
| OR | $3429.81 | — |
| PA | $2810.90 | — |
| PR | $4330.82 | — |
| RI | $3003.12 | — |
| SC | $3367.55 | — |
| SD | $2834.07 | — |
| TN | $3367.55 | — |
| TX | $3376.36 | — |
| UT | $2834.07 | — |
| VA | $2810.90 | — |
| VI | $2810.90 | — |
| VT | $3003.12 | — |
| WA | $3429.81 | — |
| WI | $3299.01 | — |
| WV | $2810.90 | — |
| WY | $2834.07 | — |
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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