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L5991 — Addition to lower extremity prostheses, osseointegrated external prosthetic connector

HCPCS Level II L-code · short descriptor: “Low pros ext osseo connector”

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.

L5991 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable: $11755.04 in all listed states.

Former-CBA payment limits: ceiling $14106.05 · floor $10579.54

StateNon-ruralRural
AK$11755.04
AL$11755.04
AR$11755.04
AZ$11755.04
CA$11755.04
CO$11755.04
CT$11755.04
DC$11755.04
DE$11755.04
FL$11755.04
GA$11755.04
HI$11755.04
IA$11755.04
ID$11755.04
IL$11755.04
IN$11755.04
KS$11755.04
KY$11755.04
LA$11755.04
MA$11755.04
MD$11755.04
ME$11755.04
MI$11755.04
MN$11755.04
MO$11755.04
MS$11755.04
MT$11755.04
NC$11755.04
ND$11755.04
NE$11755.04
NH$11755.04
NJ$11755.04
NM$11755.04
NV$11755.04
NY$11755.04
OH$11755.04
OK$11755.04
OR$11755.04
PA$11755.04
PR$11755.04
RI$11755.04
SC$11755.04
SD$11755.04
TN$11755.04
TX$11755.04
UT$11755.04
VA$11755.04
VI$11755.04
VT$11755.04
WA$11755.04
WI$11755.04
WV$11755.04
WY$11755.04
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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