L5460 — Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee
HCPCS Level II L-code · short descriptor: “Postop app non-wgt bear dsg”
- 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.
L5460 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $452.25 to $890.08 depending on state and rural status.
Former-CBA payment limits: ceiling $890.08 · floor $667.56
| State | Non-rural | Rural |
|---|---|---|
| AK | $452.25 | — |
| AL | $667.75 | — |
| AR | $890.08 | — |
| AZ | $667.56 | — |
| CA | $667.56 | — |
| CO | $702.55 | — |
| CT | $733.33 | — |
| DC | $774.50 | — |
| DE | $774.50 | — |
| FL | $667.75 | — |
| GA | $667.75 | — |
| HI | $483.57 | — |
| IA | $790.40 | — |
| ID | $715.17 | — |
| IL | $763.82 | — |
| IN | $763.82 | — |
| KS | $790.40 | — |
| KY | $667.75 | — |
| LA | $890.08 | — |
| MA | $733.33 | — |
| MD | $774.50 | — |
| ME | $733.33 | — |
| MI | $763.82 | — |
| MN | $763.82 | — |
| MO | $790.40 | — |
| MS | $667.75 | — |
| MT | $702.55 | — |
| NC | $667.75 | — |
| ND | $702.55 | — |
| NE | $790.40 | — |
| NH | $733.33 | — |
| NJ | $667.56 | — |
| NM | $890.08 | — |
| NV | $667.56 | — |
| NY | $667.56 | — |
| OH | $763.82 | — |
| OK | $890.08 | — |
| OR | $715.17 | — |
| PA | $774.50 | — |
| PR | $460.09 | — |
| RI | $733.33 | — |
| SC | $667.75 | — |
| SD | $702.55 | — |
| TN | $667.75 | — |
| TX | $890.08 | — |
| UT | $702.55 | — |
| VA | $774.50 | — |
| VI | $667.56 | — |
| VT | $733.33 | — |
| WA | $715.17 | — |
| WI | $763.82 | — |
| WV | $774.50 | — |
| WY | $702.55 | — |
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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