L5980 — All lower extremity prostheses, flex foot system
HCPCS Level II L-code · short descriptor: “Flex foot system” · 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
- Status
- Active (April 2026 HCPCS)
Prior authorization
PA REQUIRED L5980 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 (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.
L5980 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $4539.15 to $6928.90 depending on state and rural status.
Former-CBA payment limits: ceiling $6052.20 · floor $4539.15
| State | Non-rural | Rural |
|---|---|---|
| AK | $5429.04 | — |
| AL | $4539.15 | — |
| AR | $4801.22 | — |
| AZ | $5166.71 | — |
| CA | $5166.71 | — |
| CO | $6052.20 | — |
| CT | $5328.59 | — |
| DC | $4539.15 | — |
| DE | $4539.15 | — |
| FL | $4539.15 | — |
| GA | $4539.15 | — |
| HI | $5805.29 | — |
| IA | $5051.89 | — |
| ID | $4963.11 | — |
| IL | $4677.59 | — |
| IN | $4677.59 | — |
| KS | $5051.89 | — |
| KY | $4539.15 | — |
| LA | $4801.22 | — |
| MA | $5328.59 | — |
| MD | $4539.15 | — |
| ME | $5328.59 | — |
| MI | $4677.59 | — |
| MN | $4677.59 | — |
| MO | $5051.89 | — |
| MS | $4539.15 | — |
| MT | $6052.20 | — |
| NC | $4539.15 | — |
| ND | $6052.20 | — |
| NE | $5051.89 | — |
| NH | $5328.59 | — |
| NJ | $5960.65 | — |
| NM | $4801.22 | — |
| NV | $5166.71 | — |
| NY | $5960.65 | — |
| OH | $4677.59 | — |
| OK | $4801.22 | — |
| OR | $4963.11 | — |
| PA | $4539.15 | — |
| PR | $6928.90 | — |
| RI | $5328.59 | — |
| SC | $4539.15 | — |
| SD | $6052.20 | — |
| TN | $4539.15 | — |
| TX | $4801.22 | — |
| UT | $6052.20 | — |
| VA | $4539.15 | — |
| VI | $5960.63 | — |
| VT | $5328.59 | — |
| WA | $4963.11 | — |
| WI | $4677.59 | — |
| WV | $4539.15 | — |
| WY | $6052.20 | — |
Common denial codes to watch
Related L-codes
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