MyMedi-AI

L5615 — Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control

HCPCS Level II L-code · short descriptor: “Ak 4 bar link hydl swg/stanc”

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
Face-to-face & WOPD
Not on the required list
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L5615 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $6603.89 to $9833.55 depending on state and rural status.

StateNon-ruralRural
AK$9196.12—
AL$6841.95—
AR$6796.20—
AZ$8770.77—
CA$8770.77—
CO$7938.35—
CT$9042.30—
DC$6833.63—
DE$6833.63—
FL$6841.95—
GA$6841.95—
HI$9833.55—
IA$7785.57—
ID$6603.89—
IL$6927.99—
IN$6927.99—
KS$7785.57—
KY$6841.95—
LA$6796.20—
MA$9042.30—
MD$6833.63—
ME$9042.30—
MI$6927.99—
MN$6927.99—
MO$7785.57—
MS$6841.95—
MT$7938.35—
NC$6841.95—
ND$7938.35—
NE$7785.57—
NH$9042.30—
NJ$7534.30—
NM$6796.20—
NV$8770.77—
NY$7534.30—
OH$6927.99—
OK$6796.20—
OR$6603.89—
PA$6833.63—
PR$7324.40—
RI$9042.30—
SC$6841.95—
SD$7938.35—
TN$6841.95—
TX$6796.20—
UT$7938.35—
VA$6833.63—
VI$7170.86—
VT$9042.30—
WA$6603.89—
WI$6927.99—
WV$6833.63—
WY$7938.35—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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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