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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.

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 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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