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HCPCS L-codes — Orthotics & prosthetics

L-codes span orthotics and prosthetics — spinal and knee orthoses, ankle-foot orthoses, and lower-limb prosthetic components. Several off-the-shelf and custom-fabricated orthoses now require Medicare prior authorization.

933 active codes in the April 2026 HCPCS file. PA = on Medicare's required prior-authorization list · Fee schedule = April 2026 DMEPOS amounts published.

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CodeDescriptionFlags
L3550 Orthopedic shoe addition, toe tap standard Fee schedule
L3560 Orthopedic shoe addition, toe tap, horseshoe Fee schedule
L3570 Orthopedic shoe addition, special extension to instep (leather with eyelets) Fee schedule
L3580 Orthopedic shoe addition, convert instep to velcro closure Fee schedule
L3590 Orthopedic shoe addition, convert firm shoe counter to soft counter Fee schedule
L3595 Orthopedic shoe addition, march bar Fee schedule
L3600 Transfer of an orthosis from one shoe to another, caliper plate, existing Fee schedule
L3610 Transfer of an orthosis from one shoe to another, caliper plate, new Fee schedule
L3620 Transfer of an orthosis from one shoe to another, solid stirrup, existing Fee schedule
L3630 Transfer of an orthosis from one shoe to another, solid stirrup, new Fee schedule
L3640 Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes Fee schedule
L3649 Orthopedic shoe, modification, addition or transfer, not otherwise specified
L3650 Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf Fee schedule
L3660 Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf Fee schedule
L3670 Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf Fee schedule
L3671 Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3674 Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3675 Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf Fee schedule
L3677 Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L3678 Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf
L3702 Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3710 Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf Fee schedule
L3720 Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated Fee schedule
L3730 Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated Fee schedule
L3740 Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated Fee schedule
L3760 Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L3761 Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf Fee schedule
L3762 Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf Fee schedule
L3763 Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3764 Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3765 Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3766 Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3806 Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3807 Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L3808 Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment Fee schedule
L3809 Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type Fee schedule
L3891 Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each
L3900 Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated Fee schedule
L3901 Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated Fee schedule
L3904 Wrist hand finger orthosis, external powered, electric, custom fabricated Fee schedule
L3905 Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3906 Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf Fee schedule
L3912 Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf Fee schedule
L3913 Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3915 Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L3916 Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf Fee schedule
L3917 Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L3918 Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf Fee schedule
L3919 Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3921 Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3923 Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L3924 Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf Fee schedule
L3925 Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf Fee schedule
L3927 Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf Fee schedule
L3929 Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L3930 Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf Fee schedule
L3931 Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment Fee schedule
L3933 Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment Fee schedule
L3935 Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment Fee schedule
L3956 Addition of joint to upper extremity orthosis, any material; per joint Fee schedule
L3960 Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment Fee schedule
L3961 Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3962 Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment Fee schedule
L3967 Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3971 Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3973 Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3975 Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3976 Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3977 Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3978 Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment Fee schedule
L3980 Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment Fee schedule
L3981 Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments Fee schedule
L3982 Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment Fee schedule
L3984 Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment Fee schedule
L3995 Addition to upper extremity orthosis, sock, fracture or equal, each Fee schedule
L3999 Upper limb orthosis, not otherwise specified
L4000 Replace girdle for spinal orthosis (ctlso or so) Fee schedule
L4002 Replacement strap, any orthosis, includes all components, any length, any type Fee schedule
L4010 Replace trilateral socket brim Fee schedule
L4020 Replace quadrilateral socket brim, molded to patient model Fee schedule
L4030 Replace quadrilateral socket brim, custom fitted Fee schedule
L4040 Replace molded thigh lacer, for custom fabricated orthosis only Fee schedule
L4045 Replace non-molded thigh lacer, for custom fabricated orthosis only Fee schedule
L4050 Replace molded calf lacer, for custom fabricated orthosis only Fee schedule
L4055 Replace non-molded calf lacer, for custom fabricated orthosis only Fee schedule
L4060 Replace high roll cuff Fee schedule
L4070 Replace proximal and distal upright for kafo Fee schedule
L4080 Replace metal bands kafo, proximal thigh Fee schedule
L4090 Replace metal bands kafo-afo, calf or distal thigh Fee schedule
L4100 Replace leather cuff kafo, proximal thigh Fee schedule
L4110 Replace leather cuff kafo-afo, calf or distal thigh Fee schedule
L4130 Replace pretibial shell Fee schedule
L4205 Repair of orthotic device, labor component, per 15 minutes Fee schedule
L4210 Repair of orthotic device, repair or replace minor parts
L4350 Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf Fee schedule
L4360 Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L4361 Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf Fee schedule
L4370 Pneumatic full leg splint, prefabricated, off-the-shelf Fee schedule
L4386 Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L4387 Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf Fee schedule
L4392 Replacement, soft interface material, static afo Fee schedule
L4394 Replace soft interface material, foot drop splint Fee schedule
L4396 Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Fee schedule
L4397 Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf Fee schedule
L4398 Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf Fee schedule
L4631 Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated Fee schedule
L5000 Partial foot, shoe insert with longitudinal arch, toe filler Fee schedule
L5010 Partial foot, molded socket, ankle height, with toe filler Fee schedule
L5020 Partial foot, molded socket, tibial tubercle height, with toe filler Fee schedule
L5050 Ankle, symes, molded socket, sach foot Fee schedule
L5060 Ankle, symes, metal frame, molded leather socket, articulated ankle/foot Fee schedule
L5100 Below knee, molded socket, shin, sach foot Fee schedule
L5105 Below knee, plastic socket, joints and thigh lacer, sach foot Fee schedule
L5150 Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot Fee schedule
L5160 Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot Fee schedule
L5200 Above knee, molded socket, single axis constant friction knee, shin, sach foot Fee schedule
L5210 Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each Fee schedule
L5220 Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each Fee schedule
L5230 Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot Fee schedule

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