L2038 HCPCS code: Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated
L2038 is the HCPCS Level II code for knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated. The 2026 Medicare DMEPOS fee schedule pays $1,642.94 to $2,190.58 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 12 of 17 L20 codes (family range $173.92–$39,772.87).
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 | 1989-01-01 |
| Last action effective | 2006-01-01 |
2026 Medicare DMEPOS fee schedule for L2038
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1,642.94 | $2,190.58 | $2,190.58 | $1,642.94 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $1,811.70 | — |
| AL | — | $1,642.94 | — |
| AR | — | $1,642.94 | — |
| AZ | — | $1,875.31 | — |
| CA | — | $1,875.31 | — |
| CO | — | $1,642.94 | — |
| CT | — | $2,190.58 | — |
| DC | — | $2,093.86 | — |
| DE | — | $2,093.86 | — |
| FL | — | $1,642.94 | — |
| GA | — | $1,642.94 | — |
| HI | — | $1,937.29 | — |
| IA | — | $1,642.94 | — |
| ID | — | $1,911.46 | — |
| IL | — | $1,642.94 | — |
| IN | — | $1,642.94 | — |
| KS | — | $1,642.94 | — |
| KY | — | $1,642.94 | — |
| LA | — | $1,642.94 | — |
| MA | — | $2,190.58 | — |
| MD | — | $2,093.86 | — |
| ME | — | $2,190.58 | — |
| MI | — | $1,642.94 | — |
| MN | — | $1,642.94 | — |
| MO | — | $1,642.94 | — |
| MS | — | $1,642.94 | — |
| MT | — | $1,642.94 | — |
| NC | — | $1,642.94 | — |
| ND | — | $1,642.94 | — |
| NE | — | $1,642.94 | — |
| NH | — | $2,190.58 | — |
| NJ | — | $2,158.33 | — |
| NM | — | $1,642.94 | — |
| NV | — | $1,875.31 | — |
| NY | — | $2,158.33 | — |
| OH | — | $1,642.94 | — |
| OK | — | $1,642.94 | — |
| OR | — | $1,911.46 | — |
| PA | — | $2,093.86 | — |
| PR | — | $2,093.90 | — |
| RI | — | $2,190.58 | — |
| SC | — | $1,642.94 | — |
| SD | — | $1,642.94 | — |
| TN | — | $1,642.94 | — |
| TX | — | $1,642.94 | — |
| UT | — | $1,642.94 | — |
| VA | — | $2,093.86 | — |
| VI | — | $2,158.33 | — |
| VT | — | $2,190.58 | — |
| WA | — | $1,911.46 | — |
| WI | — | $1,642.94 | — |
| WV | — | $2,093.86 | — |
| WY | — | $1,642.94 | — |
How the L2038 fee compares
| Measure | Value |
|---|---|
| Rank among 17 L20 codes (lowest = 1) | 12 |
| Family fee range (average of state fees) | $173.92–$39,772.87 |
| 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 |
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 L2038
- 2026-01-01: Average state fee rose 2.0%: $1,794.86 to $1,830.76
- 1989-01-01: L2038 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 L2038?
L2038 is the HCPCS Level II code for knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated. Short descriptor: "Kafo w/o joint multi-axis an".
How much does Medicare pay for L2038?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,642.94–$2,190.58. Rural fees can be higher.
Does Medicare cover L2038?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L2038?
Medicare policy articles that cite L2038 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 L2038 change in 2026?
The average non-rural state fee moved from $1,794.86 in 2025 to $1,830.76 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2038 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L20 codes
- L2000 — Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated ($1,165.54–$2,572.50)
- L2005 — Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated ($4,915.21–$5,406.75)
- L2006 — Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated ($38,584.76–$44,514.91)
- L2010 — Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated ($1,062.50–$2,247.91)
- L2020 — Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated ($1,341.77–$3,211.79)
- L2030 — Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated ($1,164.11–$1,944.13)
- L2034 — Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated ($2,400.14–$2,850.68)
- L2035 — Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment ($207.77–$249.34)
- L2036 — Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated ($2,131.99–$4,092.63)
- L2037 — Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated ($1,913.97–$2,959.04)
- L2040 — Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated ($151.04–$265.10)
- L2050 — Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated ($547.39–$1,025.08)
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 L2038
- Watch L2038 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2038
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.