HCPCS Codes for Orthotics and Prosthetics (L-Codes)

L-codes cover orthotics and prosthetics in HCPCS Level II, ranging from simple prefabricated wrist splints to complex microprocessor-controlled prosthetic limbs. They are used by licensed orthotists and prosthetists (O&P) enrolled with Medicare, and they are paid under the DMEPOS fee schedule. Browse L-codes by filtering the code browser to L.

Each L-code describes a specific type of device or component. Orthotic codes are organized by body region and by whether the device is prefabricated (off-the-shelf) or custom fabricated. Prosthetic codes are organized by limb and functional level. For prosthetic lower limbs, the patient's Medicare Functional Classification Level (K-level) determines which prosthetic components are covered — K0 (not a prosthetic candidate) through K4 (high activity).

O&P billing requires a physician's prescription and, for certain items, detailed written orders and clinical documentation. Some high-cost L-codes require prior authorization before the device can be fitted and billed. Fitting a device before authorization is granted can result in a non-covered claim with no appeal pathway.

L-codes change less frequently than drug codes, but updates still occur. New prosthetic technologies receive L-codes when Medicare approves coverage, and outdated devices lose their codes when discontinued. Review the quarterly changes for L-code additions or deletions that might affect your O&P practice or the patients you serve.