L5410 — Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment
HCPCS Level II L-code · short descriptor: “Postop dsg bk ea add cast ch”
- 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.
L5410 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $265.71 to $682.01 depending on state and rural status.
Former-CBA payment limits: ceiling $682.01 · floor $511.51
| State | Non-rural | Rural |
|---|---|---|
| AK | $400.13 | — |
| AL | $511.51 | — |
| AR | $682.01 | — |
| AZ | $511.51 | — |
| CA | $511.51 | — |
| CO | $511.51 | — |
| CT | $562.64 | — |
| DC | $645.54 | — |
| DE | $645.54 | — |
| FL | $511.51 | — |
| GA | $511.51 | — |
| HI | $427.83 | — |
| IA | $615.96 | — |
| ID | $629.34 | — |
| IL | $542.75 | — |
| IN | $542.75 | — |
| KS | $615.96 | — |
| KY | $511.51 | — |
| LA | $682.01 | — |
| MA | $562.64 | — |
| MD | $645.54 | — |
| ME | $562.64 | — |
| MI | $542.75 | — |
| MN | $542.75 | — |
| MO | $615.96 | — |
| MS | $511.51 | — |
| MT | $511.51 | — |
| NC | $511.51 | — |
| ND | $511.51 | — |
| NE | $615.96 | — |
| NH | $562.64 | — |
| NJ | $511.51 | — |
| NM | $682.01 | — |
| NV | $511.51 | — |
| NY | $511.51 | — |
| OH | $542.75 | — |
| OK | $682.01 | — |
| OR | $629.34 | — |
| PA | $645.54 | — |
| PR | $265.71 | — |
| RI | $562.64 | — |
| SC | $511.51 | — |
| SD | $511.51 | — |
| TN | $511.51 | — |
| TX | $682.01 | — |
| UT | $511.51 | — |
| VA | $645.54 | — |
| VI | $511.51 | — |
| VT | $562.64 | — |
| WA | $629.34 | — |
| WI | $542.75 | — |
| WV | $645.54 | — |
| WY | $511.51 | — |
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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