L5930 — Addition, endoskeletal system, high activity knee control frame
HCPCS Level II L-code · short descriptor: “High activity knee frame”
- 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.
L5930 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $4045.31 to $4449.83 depending on state and rural status.
Former-CBA payment limits: ceiling $4968.33 · floor $3726.25
| State | Non-rural | Rural |
|---|---|---|
| AK | $4085.76 | — |
| AL | $4167.07 | — |
| AR | $4166.69 | — |
| AZ | $4045.31 | — |
| CA | $4045.31 | — |
| CO | $4177.01 | — |
| CT | $4249.44 | — |
| DC | $4045.31 | — |
| DE | $4045.31 | — |
| FL | $4167.07 | — |
| GA | $4167.07 | — |
| HI | $4368.92 | — |
| IA | $4120.07 | — |
| ID | $4045.31 | — |
| IL | $4144.66 | — |
| IN | $4144.66 | — |
| KS | $4120.07 | — |
| KY | $4167.07 | — |
| LA | $4166.69 | — |
| MA | $4249.44 | — |
| MD | $4045.31 | — |
| ME | $4249.44 | — |
| MI | $4144.66 | — |
| MN | $4144.66 | — |
| MO | $4120.07 | — |
| MS | $4167.07 | — |
| MT | $4177.01 | — |
| NC | $4167.07 | — |
| ND | $4177.01 | — |
| NE | $4120.07 | — |
| NH | $4249.44 | — |
| NJ | $4126.49 | — |
| NM | $4166.69 | — |
| NV | $4045.31 | — |
| NY | $4126.49 | — |
| OH | $4144.66 | — |
| OK | $4166.69 | — |
| OR | $4045.31 | — |
| PA | $4045.31 | — |
| PR | $4449.83 | — |
| RI | $4249.44 | — |
| SC | $4167.07 | — |
| SD | $4177.01 | — |
| TN | $4167.07 | — |
| TX | $4166.69 | — |
| UT | $4177.01 | — |
| VA | $4045.31 | — |
| VI | $4449.83 | — |
| VT | $4249.44 | — |
| WA | $4045.31 | — |
| WI | $4144.66 | — |
| WV | $4045.31 | — |
| WY | $4177.01 | — |
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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