L1990 HCPCS code: Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated
L1990 is the HCPCS Level II code for ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated. The 2026 Medicare DMEPOS fee schedule pays $512.22 to $1,237.32 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. Its average fee ranks 9 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 | 1982-01-01 |
| Last action effective | 2001-01-01 |
2026 Medicare DMEPOS fee schedule for L1990
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $512.22 | $1,237.32 | $682.96 | $512.22 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $874.24 | — |
| AL | — | $541.86 | — |
| AR | — | $512.22 | — |
| AZ | — | $682.96 | — |
| CA | — | $682.96 | — |
| CO | — | $512.22 | — |
| CT | — | $649.01 | — |
| DC | — | $512.22 | — |
| DE | — | $512.22 | — |
| FL | — | $541.86 | — |
| GA | — | $541.86 | — |
| HI | — | $934.81 | — |
| IA | — | $591.24 | — |
| ID | — | $651.75 | — |
| IL | — | $574.30 | — |
| IN | — | $574.30 | — |
| KS | — | $591.24 | — |
| KY | — | $541.86 | — |
| LA | — | $512.22 | — |
| MA | — | $649.01 | — |
| MD | — | $512.22 | — |
| ME | — | $649.01 | — |
| MI | — | $574.30 | — |
| MN | — | $574.30 | — |
| MO | — | $591.24 | — |
| MS | — | $541.86 | — |
| MT | — | $512.22 | — |
| NC | — | $541.86 | — |
| ND | — | $512.22 | — |
| NE | — | $591.24 | — |
| NH | — | $649.01 | — |
| NJ | — | $610.87 | — |
| NM | — | $512.22 | — |
| NV | — | $682.96 | — |
| NY | — | $610.87 | — |
| OH | — | $574.30 | — |
| OK | — | $512.22 | — |
| OR | — | $651.75 | — |
| PA | — | $512.22 | — |
| PR | — | $1,237.32 | — |
| RI | — | $649.01 | — |
| SC | — | $541.86 | — |
| SD | — | $512.22 | — |
| TN | — | $541.86 | — |
| TX | — | $512.22 | — |
| UT | — | $512.22 | — |
| VA | — | $512.22 | — |
| VI | — | $610.86 | — |
| VT | — | $649.01 | — |
| WA | — | $651.75 | — |
| WI | — | $574.30 | — |
| WV | — | $512.22 | — |
| WY | — | $512.22 | — |
How the L1990 fee compares
| Measure | Value |
|---|---|
| Rank among 20 L19 codes (lowest = 1) | 9 |
| Family fee range (average of state fees) | $102.92–$1,226.57 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
What changed for L1990
- 2026-01-01: Average state fee rose 2.0%: $585.10 to $596.80
- 1982-01-01: L1990 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 L1990?
L1990 is the HCPCS Level II code for ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated. Short descriptor: "Afo doub solid stirrup calf".
How much does Medicare pay for L1990?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $512.22–$1,237.32. Rural fees can be higher.
Does Medicare cover L1990?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L1990 change in 2026?
The average non-rural state fee moved from $585.10 in 2025 to $596.80 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L1990 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 L1990
- Watch L1990 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L1990
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.