L1960 HCPCS code: Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated

L1960 is the HCPCS Level II code for ankle foot orthosis, posterior solid ankle, plastic, custom fabricated. The 2026 Medicare DMEPOS fee schedule pays $636.95 to $1,522.87 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 9% from 2022 to 2024 (10,996 to 10,053 services). In 2024, 1,932 suppliers billed Medicare for L1960 (purchases), serving 8,406 beneficiaries; New York, California, Illinois accounted for 22% of services. Its average fee ranks 13 of 20 L19 codes (family range $102.92–$1,226.57).

Code details

FieldValue
SectionL codes — Orthotic and prosthetic procedures and devices
Coverage codeC — Carrier judgment
Pricing indicator38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services
BETOS categoryD1F — Prosthetic and orthotic devices
Added1982-01-01
Last action effective2001-01-01

2026 Medicare DMEPOS fee schedule for L1960

ModifierMeaningLowest state feeHighest state feeCeilingFloor
—base fee$636.95$1,522.87$849.26$636.95
StateModifierFeeRural fee
AK—$911.79—
AL—$636.95—
AR—$636.95—
AZ—$849.26—
CA—$849.26—
CO—$636.95—
CT—$849.26—
DC—$679.46—
DE—$679.46—
FL—$636.95—
GA—$636.95—
HI—$975.00—
IA—$636.95—
ID—$636.95—
IL—$761.80—
IN—$761.80—
KS—$636.95—
KY—$636.95—
LA—$636.95—
MA—$849.26—
MD—$679.46—
ME—$849.26—
MI—$761.80—
MN—$761.80—
MO—$636.95—
MS—$636.95—
MT—$636.95—
NC—$636.95—
ND—$636.95—
NE—$636.95—
NH—$849.26—
NJ—$849.26—
NM—$636.95—
NV—$849.26—
NY—$849.26—
OH—$761.80—
OK—$636.95—
OR—$636.95—
PA—$679.46—
PR—$1,522.87—
RI—$849.26—
SC—$636.95—
SD—$636.95—
TN—$636.95—
TX—$636.95—
UT—$636.95—
VA—$679.46—
VI—$849.26—
VT—$849.26—
WA—$636.95—
WI—$761.80—
WV—$679.46—
WY—$636.95—

How the L1960 fee compares

MeasureValue
Rank among 20 L19 codes (lowest = 1)13
Family fee range (average of state fees)$102.92–$1,226.57
Rural fee uplift—

Who bills L1960 (2024)

MeasureValue
Suppliers billing rentals—
Suppliers billing purchases1,932
Referring clinicians6,685
Medicare beneficiaries8,406
States with claims50
Share of services in top 3 states (New York, California, Illinois)22%
YearSuppliersBeneficiaries
20222,1429,252
20232,0318,790
20241,9328,406

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

Medicare utilization for L1960, 2022–2024

YearServicesBeneficiariesAvg. allowedAvg. paid
202210,9969,252$626.50$482.45
202310,5568,790$682.47$524.15
202410,0538,406$699.38$536.47

States with the most L1960 services (2024)

StateServicesAvg. paid
New York772$621.05
California716$622.65
Illinois699$555.94
Texas639$466.53
Ohio473$552.80

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
DME suppliers2Anatomic Consideration
outpatient hospital claims2Anatomic Consideration

Medicare policy articles for this code

Covered diagnoses (12 ICD-10-CM codes)

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

ICD-10-CMDiagnosisArticles listing it
A52.16Charcot's arthropathy (tabetic)1
E08.610Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy1
E09.610Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy1
E10.610Type 1 diabetes mellitus with diabetic neuropathic arthropathy1
E11.610Type 2 diabetes mellitus with diabetic neuropathic arthropathy1
M14.671Charcot's joint, right ankle and foot1
M14.672Charcot's joint, left ankle and foot1
M24.571Contracture, right ankle1
M24.572Contracture, left ankle1
M24.574Contracture, right foot1

Showing 10 of 12. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for L1960

Frequently asked questions

What is HCPCS code L1960?

L1960 is the HCPCS Level II code for ankle foot orthosis, posterior solid ankle, plastic, custom fabricated. Short descriptor: "Afo pos solid ank plastic mo".

How much does Medicare pay for L1960?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $636.95–$1,522.87. Rural fees can be higher.

Does Medicare cover L1960?

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

Which diagnoses support coverage for L1960?

Medicare policy articles that cite L1960 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 L1960 change in 2026?

The average non-rural state fee moved from $717.89 in 2025 to $732.25 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of L1960 can be billed per day?

2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).

Related L19 codes

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

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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