L5686 — Addition to lower extremity, below knee, back check (extension control)
HCPCS Level II L-code · short descriptor: “Bk back check”
- 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.
L5686 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $40.94 to $83.40 depending on state and rural status.
Former-CBA payment limits: ceiling $83.40 · floor $62.55
| State | Non-rural | Rural |
|---|---|---|
| AK | $76.44 | — |
| AL | $62.55 | — |
| AR | $66.14 | — |
| AZ | $75.99 | — |
| CA | $75.99 | — |
| CO | $73.89 | — |
| CT | $73.73 | — |
| DC | $79.48 | — |
| DE | $79.48 | — |
| FL | $62.55 | — |
| GA | $62.55 | — |
| HI | $81.71 | — |
| IA | $67.43 | — |
| ID | $78.04 | — |
| IL | $70.87 | — |
| IN | $70.87 | — |
| KS | $67.43 | — |
| KY | $62.55 | — |
| LA | $66.14 | — |
| MA | $73.73 | — |
| MD | $79.48 | — |
| ME | $73.73 | — |
| MI | $70.87 | — |
| MN | $70.87 | — |
| MO | $67.43 | — |
| MS | $62.55 | — |
| MT | $73.89 | — |
| NC | $62.55 | — |
| ND | $73.89 | — |
| NE | $67.43 | — |
| NH | $73.73 | — |
| NJ | $83.40 | — |
| NM | $66.14 | — |
| NV | $75.99 | — |
| NY | $83.40 | — |
| OH | $70.87 | — |
| OK | $66.14 | — |
| OR | $78.04 | — |
| PA | $79.48 | — |
| PR | $40.94 | — |
| RI | $73.73 | — |
| SC | $62.55 | — |
| SD | $73.89 | — |
| TN | $62.55 | — |
| TX | $66.14 | — |
| UT | $73.89 | — |
| VA | $79.48 | — |
| VI | $83.40 | — |
| VT | $73.73 | — |
| WA | $78.04 | — |
| WI | $70.87 | — |
| WV | $79.48 | — |
| WY | $73.89 | — |
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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