L1902 HCPCS code: Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf
L1902 is the HCPCS Level II code for ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf. The 2026 Medicare DMEPOS fee schedule pays $85.68 to $122.31 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 fell 3% from 2022 to 2024 (62,205 to 60,440 services). In 2024, 4,987 suppliers billed Medicare for L1902 (purchases), serving 58,070 beneficiaries; California, Florida, New York accounted for 18% of services. Its average fee ranks 1 of 20 L19 codes (family range $102.92–$1,226.57).
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 | 1988-01-01 |
| Last action effective | 2016-01-01 |
2026 Medicare DMEPOS fee schedule for L1902
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $85.68 | $122.31 | $122.31 | $91.73 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $108.65 | — |
| AL | — | $94.39 | — |
| AR | — | $122.31 | — |
| AZ | — | $105.11 | — |
| CA | — | $105.11 | — |
| CO | — | $91.73 | — |
| CT | — | $105.66 | — |
| DC | — | $107.12 | — |
| DE | — | $107.12 | — |
| FL | — | $94.39 | — |
| GA | — | $94.39 | — |
| HI | — | $116.17 | — |
| IA | — | $96.81 | — |
| ID | — | $112.48 | — |
| IL | — | $91.73 | — |
| IN | — | $91.73 | — |
| KS | — | $96.81 | — |
| KY | — | $94.39 | — |
| LA | — | $122.31 | — |
| MA | — | $105.66 | — |
| MD | — | $107.12 | — |
| ME | — | $105.66 | — |
| MI | — | $91.73 | — |
| MN | — | $91.73 | — |
| MO | — | $96.81 | — |
| MS | — | $94.39 | — |
| MT | — | $91.73 | — |
| NC | — | $94.39 | — |
| ND | — | $91.73 | — |
| NE | — | $96.81 | — |
| NH | — | $105.66 | — |
| NJ | — | $120.04 | — |
| NM | — | $122.31 | — |
| NV | — | $105.11 | — |
| NY | — | $120.04 | — |
| OH | — | $91.73 | — |
| OK | — | $122.31 | — |
| OR | — | $112.48 | — |
| PA | — | $107.12 | — |
| PR | — | $85.68 | — |
| RI | — | $105.66 | — |
| SC | — | $94.39 | — |
| SD | — | $91.73 | — |
| TN | — | $94.39 | — |
| TX | — | $122.31 | — |
| UT | — | $91.73 | — |
| VA | — | $107.12 | — |
| VI | — | $120.02 | — |
| VT | — | $105.66 | — |
| WA | — | $112.48 | — |
| WI | — | $91.73 | — |
| WV | — | $107.12 | — |
| WY | — | $91.73 | — |
How the L1902 fee compares
| Measure | Value |
|---|---|
| Rank among 20 L19 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $102.92–$1,226.57 |
| Rural fee uplift | — |
Who bills L1902 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 4,987 |
| Referring clinicians | 18,344 |
| Medicare beneficiaries | 58,070 |
| States with claims | 51 |
| Share of services in top 3 states (California, Florida, New York) | 18% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 5,506 | 59,299 |
| 2023 | 5,299 | 59,099 |
| 2024 | 4,987 | 58,070 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L1902, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 62,205 | 59,299 | $86.66 | $65.18 |
| 2023 | 61,766 | 59,099 | $94.15 | $70.59 |
| 2024 | 60,440 | 58,070 | $96.61 | $72.32 |
States with the most L1902 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 3,877 | $74.44 |
| Florida | 3,710 | $67.71 |
| New York | 3,139 | $82.56 |
| Pennsylvania | 2,979 | $75.36 |
| Texas | 2,977 | $82.63 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
Medicare policy articles for this code
- A52457: Ankle-Foot/Knee-Ankle-Foot Orthoses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (12 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A52.16 | Charcot's arthropathy (tabetic) | 1 |
| E08.610 | Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy | 1 |
| E09.610 | Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy | 1 |
| E10.610 | Type 1 diabetes mellitus with diabetic neuropathic arthropathy | 1 |
| E11.610 | Type 2 diabetes mellitus with diabetic neuropathic arthropathy | 1 |
| M14.671 | Charcot's joint, right ankle and foot | 1 |
| M14.672 | Charcot's joint, left ankle and foot | 1 |
| M24.571 | Contracture, right ankle | 1 |
| M24.572 | Contracture, left ankle | 1 |
| M24.574 | Contracture, right foot | 1 |
Showing 10 of 12. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L1902
- 2026-01-01: Average state fee rose 2.0%: $100.90 to $102.92
- 1988-01-01: L1902 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 L1902?
L1902 is the HCPCS Level II code for ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf. Short descriptor: "Afo ankle gauntlet pre ots".
How much does Medicare pay for L1902?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $85.68–$122.31. Rural fees can be higher.
Does Medicare cover L1902?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L1902?
Medicare policy articles that cite L1902 list 12 covered ICD-10-CM diagnosis codes across 1 article. The most cited include A52.16 (Charcot's arthropathy (tabetic)), E08.610 (Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy), E09.610 (Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for L1902 change in 2026?
The average non-rural state fee moved from $100.90 in 2025 to $102.92 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L1902 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L19 codes
- L1900 — Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated ($310.01–$398.09)
- L1904 — Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated ($540.36–$990.72)
- L1906 — Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf ($138.20–$318.48)
- L1907 — Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated ($674.95–$742.46)
- L1910 — Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment ($307.30–$590.09)
- L1920 — Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated ($374.16–$761.40)
- L1930 — Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment ($225.00–$459.82)
- L1932 — Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($1,070.39–$1,177.42)
- L1933 — Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf ($1,070.39–$1,177.42)
- L1940 — Ankle foot orthosis, plastic or other material, custom fabricated ($568.30–$1,522.87)
- L1945 — Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated ($780.45–$1,589.54)
- L1950 — Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated ($855.92–$1,328.25)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under L1902
- Watch L1902 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1902
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.