L1972 HCPCS code: Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf
L1972 is the HCPCS Level II code for ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
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 | 2026-10-01 |
| Last action effective | 2026-10-01 |
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
- A53058: Billing and Coding: Home Health Physical Therapy (Palmetto GBA (HHH MAC))
- A53065: Billing and Coding: Outpatient Physical Therapy (Palmetto GBA (MAC - Part A))
Covered diagnoses (13 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 13. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L1972
- October 2026: Code appears in this HCPCS release
- 2026-10-01: L1972 added to HCPCS Level II
- 2026-10-01: Last CMS action: code added
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L1972?
L1972 is the HCPCS Level II code for ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf. Short descriptor: "Ankl foot ortho, prefab, off".
Does Medicare cover L1972?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L1972?
Medicare policy articles that cite L1972 list 13 covered ICD-10-CM diagnosis codes across 3 articles. 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.
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)
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 L1972
- Watch L1972 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1972
Compiled by Caduvo from public CMS (Medicare) records, HCPCS release October 2026. Fees are Medicare allowables, not commercial rates. Not reviewed or endorsed by CMS. Not billing or legal advice. Report an error. Data and corrections policy.