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L5976 — All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)

HCPCS Level II L-code · short descriptor: “Energy storing foot”

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.

L5976 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $685.61 to $1202.12 depending on state and rural status.

Former-CBA payment limits: ceiling $914.15 · floor $685.61

StateNon-ruralRural
AK$1124.19
AL$685.61
AR$743.14
AZ$914.15
CA$914.15
CO$740.25
CT$841.19
DC$685.61
DE$685.61
FL$685.61
GA$685.61
HI$1202.12
IA$772.28
ID$766.42
IL$723.64
IN$723.64
KS$772.28
KY$685.61
LA$743.14
MA$841.19
MD$685.61
ME$841.19
MI$723.64
MN$723.64
MO$772.28
MS$685.61
MT$740.25
NC$685.61
ND$740.25
NE$772.28
NH$841.19
NJ$865.11
NM$743.14
NV$914.15
NY$865.11
OH$723.64
OK$743.14
OR$766.42
PA$685.61
PR$989.84
RI$841.19
SC$685.61
SD$740.25
TN$685.61
TX$743.14
UT$740.25
VA$685.61
VI$865.11
VT$841.19
WA$766.42
WI$723.64
WV$685.61
WY$740.25
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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