L1840 HCPCS code: Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated
L1840 is the HCPCS Level II code for knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated. The 2026 Medicare DMEPOS fee schedule pays $1,056.60 to $1,606.15 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on DME suppliers. Its average fee ranks 18 of 21 L18 codes (family range $74.67–$2,029.02).
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1986-01-01 |
| Last action effective | 2001-01-01 |
2026 Medicare DMEPOS fee schedule for L1840
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1,056.60 | $1,606.15 | $1,408.80 | $1,056.60 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $1,502.05 | — |
| AL | — | $1,151.99 | — |
| AR | — | $1,298.28 | — |
| AZ | — | $1,408.80 | — |
| CA | — | $1,408.80 | — |
| CO | — | $1,056.60 | — |
| CT | — | $1,120.91 | — |
| DC | — | $1,188.20 | — |
| DE | — | $1,188.20 | — |
| FL | — | $1,151.99 | — |
| GA | — | $1,151.99 | — |
| HI | — | $1,606.15 | — |
| IA | — | $1,082.49 | — |
| ID | — | $1,222.22 | — |
| IL | — | $1,155.72 | — |
| IN | — | $1,155.72 | — |
| KS | — | $1,082.49 | — |
| KY | — | $1,151.99 | — |
| LA | — | $1,298.28 | — |
| MA | — | $1,120.91 | — |
| MD | — | $1,188.20 | — |
| ME | — | $1,120.91 | — |
| MI | — | $1,155.72 | — |
| MN | — | $1,155.72 | — |
| MO | — | $1,082.49 | — |
| MS | — | $1,151.99 | — |
| MT | — | $1,056.60 | — |
| NC | — | $1,151.99 | — |
| ND | — | $1,056.60 | — |
| NE | — | $1,082.49 | — |
| NH | — | $1,120.91 | — |
| NJ | — | $1,189.15 | — |
| NM | — | $1,298.28 | — |
| NV | — | $1,408.80 | — |
| NY | — | $1,189.15 | — |
| OH | — | $1,155.72 | — |
| OK | — | $1,298.28 | — |
| OR | — | $1,222.22 | — |
| PA | — | $1,188.20 | — |
| PR | — | $1,522.87 | — |
| RI | — | $1,120.91 | — |
| SC | — | $1,151.99 | — |
| SD | — | $1,056.60 | — |
| TN | — | $1,151.99 | — |
| TX | — | $1,298.28 | — |
| UT | — | $1,056.60 | — |
| VA | — | $1,188.20 | — |
| VI | — | $1,189.15 | — |
| VT | — | $1,120.91 | — |
| WA | — | $1,222.22 | — |
| WI | — | $1,155.72 | — |
| WV | — | $1,188.20 | — |
| WY | — | $1,056.60 | — |
How the L1840 fee compares
| Measure | Value |
|---|---|
| Rank among 21 L18 codes (lowest = 1) | 18 |
| Family fee range (average of state fees) | $74.67–$2,029.02 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
What changed for L1840
- 2026-01-01: Average state fee rose 2.0%: $1,170.13 to $1,193.54
- 1986-01-01: L1840 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L1840?
L1840 is the HCPCS Level II code for knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated. Short descriptor: "Ko derot ant cruciate custom".
How much does Medicare pay for L1840?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,056.60–$1,606.15. Rural fees can be higher.
Does Medicare cover L1840?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L1840 change in 2026?
The average non-rural state fee moved from $1,170.13 in 2025 to $1,193.54 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L1840 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L18 codes
- L1810 — Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($113.17–$166.75)
- L1812 — Knee orthosis, elastic with joints, prefabricated, off-the-shelf ($70.12–$126.23)
- L1820 — Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($148.99–$194.23)
- L1821 — Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf ($148.99–$194.23)
- L1830 — Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf ($63.18–$149.93)
- L1831 — Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment ($353.04–$388.33)
- L1832 — Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($698.63–$1,618.03)
- L1833 — Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf ($455.16–$1,087.16)
- L1834 — Knee orthosis, without knee joint, rigid, custom fabricated ($892.02–$1,808.36)
- L1836 — Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf ($89.34–$142.64)
- L1843 — Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($1,076.26–$1,183.90)
- L1844 — Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated ($1,865.51–$2,436.24)
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Next steps
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Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.