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 (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.
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 (April 13, 2026 update — 83 items). 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 (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $6603.89 to $9833.55 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| 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 | — |
Common denial codes to watch
Related L-codes
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