MyMedi-AI

L5986 — All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)

HCPCS Level II L-code · short descriptor: “Multi-axial rotation unit”

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
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). 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 (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.

L5986 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $327.68 to $1375.26 depending on state and rural status.

Former-CBA payment limits: ceiling $1034.39 · floor $775.79

StateNon-ruralRural
AK$1286.07—
AL$775.79—
AR$818.99—
AZ$1034.39—
CA$1034.39—
CO$1034.39—
CT$794.12—
DC$779.90—
DE$779.90—
FL$775.79—
GA$775.79—
HI$1375.26—
IA$874.57—
ID$936.06—
IL$955.08—
IN$955.08—
KS$874.57—
KY$775.79—
LA$818.99—
MA$794.12—
MD$779.90—
ME$794.12—
MI$955.08—
MN$955.08—
MO$874.57—
MS$775.79—
MT$1034.39—
NC$775.79—
ND$1034.39—
NE$874.57—
NH$794.12—
NJ$775.79—
NM$818.99—
NV$1034.39—
NY$775.79—
OH$955.08—
OK$818.99—
OR$936.06—
PA$779.90—
PR$327.68—
RI$794.12—
SC$775.79—
SD$1034.39—
TN$775.79—
TX$818.99—
UT$1034.39—
VA$779.90—
VI$775.79—
VT$794.12—
WA$936.06—
WI$955.08—
WV$779.90—
WY$1034.39—
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 L5986 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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