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L5987 — All lower extremity prosthesis, shank foot system with vertical loading pylon

HCPCS Level II L-code · short descriptor: “Shank ft w vert load pylon” · 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)
Status
Active (April 2026 HCPCS)

Prior authorization

PA REQUIRED L5987 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.

L5987 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $8645.70 to $9510.31 depending on state and rural status.

Former-CBA payment limits: ceiling $10550.87 · floor $7913.15

StateNon-ruralRural
AK$8732.21
AL$8906.07
AR$8905.25
AZ$8645.73
CA$8645.73
CO$8955.19
CT$8645.70
DC$8645.71
DE$8645.71
FL$8906.07
GA$8906.07
HI$9337.39
IA$8814.60
ID$8645.73
IL$8858.10
IN$8858.10
KS$8814.60
KY$8906.07
LA$8905.25
MA$8645.70
MD$8645.71
ME$8645.70
MI$8858.10
MN$8858.10
MO$8814.60
MS$8906.07
MT$8955.19
NC$8906.07
ND$8955.19
NE$8814.60
NH$8645.70
NJ$8645.70
NM$8905.25
NV$8645.73
NY$8645.70
OH$8858.10
OK$8905.25
OR$8645.73
PA$8645.71
PR$9510.31
RI$8645.70
SC$8906.07
SD$8955.19
TN$8906.07
TX$8905.25
UT$8955.19
VA$8645.71
VI$9510.31
VT$8645.70
WA$8645.73
WI$8858.10
WV$8645.71
WY$8955.19
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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