L2114 HCPCS code: Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment
L2114 is the HCPCS Level II code for ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment. The 2026 Medicare DMEPOS fee schedule pays $666.99 to $1,125.78 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 68% from 2022 to 2024 (649 to 210 services). In 2024, 54 suppliers billed Medicare for L2114 (purchases), serving 208 beneficiaries; New York, Arizona, California accounted for 82% of services. Its average fee ranks 9 of 17 L21 codes (family range $109.80–$2,176.65).
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 | 1988-01-01 |
| Last action effective | 2001-01-01 |
2026 Medicare DMEPOS fee schedule for L2114
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $666.99 | $1,125.78 | $889.32 | $666.99 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $1,052.78 | — |
| AL | — | $666.99 | — |
| AR | — | $753.46 | — |
| AZ | — | $889.32 | — |
| CA | — | $889.32 | — |
| CO | — | $672.46 | — |
| CT | — | $784.59 | — |
| DC | — | $784.82 | — |
| DE | — | $784.82 | — |
| FL | — | $666.99 | — |
| GA | — | $666.99 | — |
| HI | — | $1,125.78 | — |
| IA | — | $704.63 | — |
| ID | — | $682.08 | — |
| IL | — | $776.59 | — |
| IN | — | $776.59 | — |
| KS | — | $704.63 | — |
| KY | — | $666.99 | — |
| LA | — | $753.46 | — |
| MA | — | $784.59 | — |
| MD | — | $784.82 | — |
| ME | — | $784.59 | — |
| MI | — | $776.59 | — |
| MN | — | $776.59 | — |
| MO | — | $704.63 | — |
| MS | — | $666.99 | — |
| MT | — | $672.46 | — |
| NC | — | $666.99 | — |
| ND | — | $672.46 | — |
| NE | — | $704.63 | — |
| NH | — | $784.59 | — |
| NJ | — | $888.63 | — |
| NM | — | $753.46 | — |
| NV | — | $889.32 | — |
| NY | — | $888.63 | — |
| OH | — | $776.59 | — |
| OK | — | $753.46 | — |
| OR | — | $682.08 | — |
| PA | — | $784.82 | — |
| PR | — | $1,056.48 | — |
| RI | — | $784.59 | — |
| SC | — | $666.99 | — |
| SD | — | $672.46 | — |
| TN | — | $666.99 | — |
| TX | — | $753.46 | — |
| UT | — | $672.46 | — |
| VA | — | $784.82 | — |
| VI | — | $888.63 | — |
| VT | — | $784.59 | — |
| WA | — | $682.08 | — |
| WI | — | $776.59 | — |
| WV | — | $784.82 | — |
| WY | — | $672.46 | — |
How the L2114 fee compares
| Measure | Value |
|---|---|
| Rank among 17 L21 codes (lowest = 1) | 9 |
| Family fee range (average of state fees) | $109.80–$2,176.65 |
| Rural fee uplift | — |
Who bills L2114 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 54 |
| Referring clinicians | 103 |
| Medicare beneficiaries | 208 |
| States with claims | 5 |
| Share of services in top 3 states (New York, Arizona, California) | 82% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 108 | 631 |
| 2023 | 71 | 358 |
| 2024 | 54 | 208 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L2114, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 649 | 631 | $570.90 | $443.60 |
| 2023 | 359 | 358 | $630.22 | $484.47 |
| 2024 | 210 | 208 | $663.52 | $513.09 |
States with the most L2114 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 62 | $628.03 |
| Arizona | 34 | $296.31 |
| California | 23 | $660.40 |
| Louisiana | 14 | $565.00 |
| Ohio | 13 | $539.50 |
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 L2114
- 2026-01-01: Average state fee rose 2.0%: $751.90 to $766.94
- 1988-01-01: L2114 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 L2114?
L2114 is the HCPCS Level II code for ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment. Short descriptor: "Afo tib fx semi-rigid".
How much does Medicare pay for L2114?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $666.99–$1,125.78. Rural fees can be higher.
Does Medicare cover L2114?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L2114?
Medicare policy articles that cite L2114 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 L2114 change in 2026?
The average non-rural state fee moved from $751.90 in 2025 to $766.94 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2114 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L21 codes
- L2106 — Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated ($781.31–$1,468.06)
- L2108 — Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated ($999.36–$1,659.98)
- L2112 — Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment ($536.14–$708.38)
- L2116 — Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment ($818.05–$1,402.58)
- L2126 — Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated ($1,376.03–$1,834.71)
- L2128 — Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated ($1,808.36–$2,786.22)
- L2132 — Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment ($926.98–$1,427.66)
- L2134 — Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment ($1,111.41–$1,713.20)
- L2136 — Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment ($1,358.95–$2,855.32)
- L2180 — Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints ($95.20–$220.62)
- L2182 — Addition to lower extremity fracture orthosis, drop lock knee joint ($47.61–$140.43)
- L2184 — Addition to lower extremity fracture orthosis, limited motion knee joint ($66.65–$189.80)
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 L2114
- Watch L2114 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2114
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.