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L7520 — Repair prosthetic device, labor component, per 15 minutes

HCPCS Level II L-code · short descriptor: “Repair prosthesis per 15 min”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
LT
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required 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.

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.

L7520 Medicare fee schedule (April 2026)

Base (no modifier) LT

Medicare allowable ranges from $40.67 to $63.34 depending on state and rural status.

StateNon-ruralRural
AK$50.77
AL$40.67
AR$40.67
AZ$50.06
CA$57.32
CO$40.67
CT$40.67
DC$40.67
DE$40.67
FL$40.67
GA$40.67
HI$50.77
IA$48.69
ID$40.67
IL$40.67
IN$40.67
KS$50.77
KY$52.00
LA$40.67
MA$40.67
MD$40.67
ME$40.67
MI$40.67
MN$40.67
MO$40.67
MS$40.67
MT$50.77
NC$40.67
ND$50.77
NE$56.71
NH$40.67
NJ$40.67
NM$40.67
NV$55.43
NY$40.67
OH$40.67
OK$40.67
OR$58.49
PA$40.67
PR$40.67
RI$40.67
SC$40.67
SD$54.38
TN$40.67
TX$40.67
UT$63.34
VA$40.67
VI$40.67
VT$40.67
WA$52.16
WI$40.67
WV$40.67
WY$56.71
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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