L1971 HCPCS code: Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment

L1971 is the HCPCS Level II code for ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment. The 2026 Medicare DMEPOS fee schedule pays $562.23 to $618.47 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 30% from 2022 to 2024 (17,387 to 12,106 services). In 2024, 681 suppliers billed Medicare for L1971 (purchases), serving 7,427 beneficiaries; California, New York, New Jersey accounted for 32% of services. Its average fee ranks 8 of 20 L19 codes (family range $102.92–$1,226.57).

Code details

2026 Medicare DMEPOS fee schedule for L1971

How the L1971 fee compares

Who bills L1971 (2024)

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

Medicare utilization for L1971, 2022–2024

States with the most L1971 services (2024)

NCCI unit limits (MUE)

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:

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

What changed for L1971

• April 2025: Descriptor revised (Was: Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment)
• 2026-01-01: Average state fee rose 2.0%: $561.94 to $573.18
• 2004-01-01: L1971 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 L1971?

L1971 is the HCPCS Level II code for ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment. Short descriptor: "Afo w/ankle joint, prefab".

How much does Medicare pay for L1971?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $562.23–$618.47. Rural fees can be higher.

Does Medicare cover L1971?

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

Which diagnoses support coverage for L1971?

Medicare policy articles that cite L1971 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 L1971 change in 2026?

The average non-rural state fee moved from $561.94 in 2025 to $573.18 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of L1971 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)
• L1902 — Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf ($85.68–$122.31)
• 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)

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Next steps

• Run a reimbursement report for a device billed under L1971
• Watch L1971 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for L1971

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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