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L5665 — Addition to lower extremity, socket insert, multi-durometer, below knee

HCPCS Level II L-code · short descriptor: “Multi-durometer below knee”

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.

L5665 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $626.84 to $1049.18 depending on state and rural status.

Former-CBA payment limits: ceiling $835.79 · floor $626.84

StateNon-ruralRural
AK$981.13
AL$626.84
AR$669.92
AZ$835.79
CA$835.79
CO$626.84
CT$835.79
DC$626.84
DE$626.84
FL$626.84
GA$626.84
HI$1049.18
IA$826.02
ID$626.84
IL$712.97
IN$712.97
KS$826.02
KY$626.84
LA$669.92
MA$835.79
MD$626.84
ME$835.79
MI$712.97
MN$712.97
MO$826.02
MS$626.84
MT$626.84
NC$626.84
ND$626.84
NE$826.02
NH$835.79
NJ$626.84
NM$669.92
NV$835.79
NY$626.84
OH$712.97
OK$669.92
OR$626.84
PA$626.84
PR$666.22
RI$835.79
SC$626.84
SD$626.84
TN$626.84
TX$669.92
UT$626.84
VA$626.84
VI$626.84
VT$835.79
WA$626.84
WI$712.97
WV$626.84
WY$626.84
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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