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L5940 — Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)

HCPCS Level II L-code · short descriptor: “Endo bk ultra-light material”

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
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.

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 (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L5940 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $614.10 to $1142.13 depending on state and rural status.

Former-CBA payment limits: ceiling $818.79 · floor $614.10

StateNon-ruralRural
AK$655.19
AL$614.10
AR$818.79
AZ$652.69
CA$652.69
CO$818.79
CT$614.10
DC$614.10
DE$614.10
FL$614.10
GA$614.10
HI$700.57
IA$814.46
ID$763.50
IL$614.10
IN$614.10
KS$814.46
KY$614.10
LA$818.79
MA$614.10
MD$614.10
ME$614.10
MI$614.10
MN$614.10
MO$814.46
MS$614.10
MT$818.79
NC$614.10
ND$818.79
NE$814.46
NH$614.10
NJ$667.12
NM$818.79
NV$652.69
NY$667.12
OH$614.10
OK$818.79
OR$763.50
PA$614.10
PR$1142.13
RI$614.10
SC$614.10
SD$818.79
TN$614.10
TX$818.79
UT$818.79
VA$614.10
VI$667.12
VT$614.10
WA$763.50
WI$614.10
WV$614.10
WY$818.79
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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