MyMedi-AI

L5973 — Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source

HCPCS Level II L-code · short descriptor: “Ank-foot sys dors-plant flex” · PA required

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
Required (Medicare, since 2020-12-01)
Face-to-face & WOPD
Not on the required list
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

PA REQUIRED L5973 is on Medicare's DMEPOS Required Prior Authorization List (Lower Limb Prosthetics — nationwide since 2020-12-01).

Claims for this item without an affirmed prior-authorization decision are automatically denied (commonly surfacing as CO-197). Submit the PA request to your DME MAC with the order and supporting clinical documentation 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.

L5973 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $20916.61 to $23785.15 depending on state and rural status.

Former-CBA payment limits: ceiling $25594.72 · floor $19196.04

StateNon-ruralRural
AK$21106.11—
AL$21299.94—
AR$21297.95—
AZ$21127.66—
CA$21127.66—
CO$21711.59—
CT$21085.93—
DC$21041.00—
DE$21041.00—
FL$21299.94—
GA$21299.94—
HI$21106.11—
IA$21540.27—
ID$21127.66—
IL$21739.52—
IN$21739.52—
KS$21540.27—
KY$21299.94—
LA$21297.95—
MA$21085.93—
MD$21041.00—
ME$21085.93—
MI$21739.52—
MN$21739.52—
MO$21540.27—
MS$21299.94—
MT$21711.59—
NC$21299.94—
ND$21711.59—
NE$21540.27—
NH$21085.93—
NJ$20916.61—
NM$21297.95—
NV$21127.66—
NY$20916.61—
OH$21739.52—
OK$21297.95—
OR$21127.66—
PA$21041.00—
PR$23785.15—
RI$21085.93—
SC$21299.94—
SD$21711.59—
TN$21299.94—
TX$21297.95—
UT$21711.59—
VA$21041.00—
VI$23065.06—
VT$21085.93—
WA$21127.66—
WI$21739.52—
WV$21041.00—
WY$21711.59—
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 L5973 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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