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L5824 — Addition, endoskeletal knee-shin system, single axis, fluid swing phase control

HCPCS Level II L-code · short descriptor: “Endo knee-shin fluid swing p”

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.

L5824 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1808.36 to $3524.23 depending on state and rural status.

Former-CBA payment limits: ceiling $2503.27 · floor $1877.46

StateNon-ruralRural
AK$3295.79
AL$1877.46
AR$2236.51
AZ$2503.27
CA$2503.27
CO$2503.27
CT$2181.35
DC$1877.46
DE$1877.46
FL$1877.46
GA$1877.46
HI$3524.23
IA$1947.22
ID$1877.46
IL$2038.76
IN$2038.76
KS$1947.22
KY$1877.46
LA$2236.51
MA$2181.35
MD$1877.46
ME$2181.35
MI$2038.76
MN$2038.76
MO$1947.22
MS$1877.46
MT$2503.27
NC$1877.46
ND$2503.27
NE$1947.22
NH$2181.35
NJ$2324.52
NM$2236.51
NV$2503.27
NY$2324.52
OH$2038.76
OK$2236.51
OR$1877.46
PA$1877.46
PR$1808.36
RI$2181.35
SC$1877.46
SD$2503.27
TN$1877.46
TX$2236.51
UT$2503.27
VA$1877.46
VI$2324.52
VT$2181.35
WA$1877.46
WI$2038.76
WV$1877.46
WY$2503.27
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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