MyMedi-AI

L5714 — Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control

HCPCS Level II L-code · short descriptor: “Knee-shin exo variable frict”

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
MUE unit limit
2
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.

L5714 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $255.56 to $626.05 depending on state and rural status.

Former-CBA payment limits: ceiling $682.76 · floor $512.07

StateNon-ruralRural
AK$585.49—
AL$550.71—
AR$587.64—
AZ$611.29—
CA$611.29—
CO$621.36—
CT$596.63—
DC$544.01—
DE$544.01—
FL$550.71—
GA$550.71—
HI$626.05—
IA$583.48—
ID$512.07—
IL$536.75—
IN$536.75—
KS$583.48—
KY$550.71—
LA$587.64—
MA$596.63—
MD$544.01—
ME$596.63—
MI$536.75—
MN$536.75—
MO$583.48—
MS$550.71—
MT$621.36—
NC$550.71—
ND$621.36—
NE$583.48—
NH$596.63—
NJ$531.19—
NM$587.64—
NV$611.29—
NY$531.19—
OH$536.75—
OK$587.64—
OR$512.07—
PA$544.01—
PR$255.56—
RI$596.63—
SC$550.71—
SD$621.36—
TN$550.71—
TX$587.64—
UT$621.36—
VA$544.01—
VI$531.18—
VT$596.63—
WA$512.07—
WI$536.75—
WV$544.01—
WY$621.36—
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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L5714 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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