L1850 HCPCS code: Knee orthosis, swedish type, prefabricated, off-the-shelf

L1850 is the HCPCS Level II code for knee orthosis, swedish type, prefabricated, off-the-shelf. The 2026 Medicare DMEPOS fee schedule pays $205.78 to $408.53 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. Medicare volume rose 31% from 2022 to 2024 (191 to 251 services). In 2024, 141 suppliers billed Medicare for L1850 (purchases), serving 239 beneficiaries; Utah, California, Missouri accounted for 77% of services. Its average fee ranks 7 of 21 L18 codes (family range $74.67–$2,029.02); rural fees run 29% higher.

Code details

2026 Medicare DMEPOS fee schedule for L1850

How the L1850 fee compares

Who bills L1850 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for L1850, 2022–2024

States with the most L1850 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52465: Knee Orthoses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (4,806 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 4,806. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for L1850

• 2026-01-01: Average state fee rose 2.6%: $234.39 to $240.59
• 1982-01-01: L1850 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 L1850?

L1850 is the HCPCS Level II code for knee orthosis, swedish type, prefabricated, off-the-shelf. Short descriptor: "Ko swedish type pre ots".

How much does Medicare pay for L1850?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $205.78–$408.53. Rural fees can be higher.

Does Medicare cover L1850?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for L1850?

Medicare policy articles that cite L1850 list 4,806 covered ICD-10-CM diagnosis codes across 1 article. The most cited include G04.1 (Tropical spastic paraplegia), G35.A (Relapsing-remitting multiple sclerosis), G35.B0 (Primary progressive multiple sclerosis, unspecified). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for L1850 change in 2026?

The average non-rural state fee moved from $234.39 in 2025 to $240.59 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of L1850 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)
• L1840 — Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated ($1,056.60–$1,606.15)
• 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)

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Next steps

• Run a reimbursement report for a device billed under L1850
• Watch L1850 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for L1850

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.

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