L2220 HCPCS code: Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint
L2220 is the HCPCS Level II code for addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint. The 2026 Medicare DMEPOS fee schedule pays $94.10 to $196.92 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 4 per day on DME suppliers. Medicare volume fell 6% from 2022 to 2024 (8,786 to 8,266 services). In 2024, 1,226 suppliers billed Medicare for L2220 (purchases), serving 3,857 beneficiaries; California, New York, Pennsylvania accounted for 32% of services. Its average fee ranks 5 of 12 L22 codes (family range $64.40–$580.99).
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 | 1986-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L2220
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $94.10 | $196.92 | $125.47 | $94.10 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $184.18 | — |
| AL | — | $101.79 | — |
| AR | — | $100.40 | — |
| AZ | — | $125.47 | — |
| CA | — | $125.47 | — |
| CO | — | $121.93 | — |
| CT | — | $94.10 | — |
| DC | — | $94.10 | — |
| DE | — | $94.10 | — |
| FL | — | $101.79 | — |
| GA | — | $101.79 | — |
| HI | — | $196.92 | — |
| IA | — | $96.48 | — |
| ID | — | $111.21 | — |
| IL | — | $99.43 | — |
| IN | — | $99.43 | — |
| KS | — | $96.48 | — |
| KY | — | $101.79 | — |
| LA | — | $100.40 | — |
| MA | — | $94.10 | — |
| MD | — | $94.10 | — |
| ME | — | $94.10 | — |
| MI | — | $99.43 | — |
| MN | — | $99.43 | — |
| MO | — | $96.48 | — |
| MS | — | $101.79 | — |
| MT | — | $121.93 | — |
| NC | — | $101.79 | — |
| ND | — | $121.93 | — |
| NE | — | $96.48 | — |
| NH | — | $94.10 | — |
| NJ | — | $106.75 | — |
| NM | — | $100.40 | — |
| NV | — | $125.47 | — |
| NY | — | $106.75 | — |
| OH | — | $99.43 | — |
| OK | — | $100.40 | — |
| OR | — | $111.21 | — |
| PA | — | $94.10 | — |
| PR | — | $95.20 | — |
| RI | — | $94.10 | — |
| SC | — | $101.79 | — |
| SD | — | $121.93 | — |
| TN | — | $101.79 | — |
| TX | — | $100.40 | — |
| UT | — | $121.93 | — |
| VA | — | $94.10 | — |
| VI | — | $106.75 | — |
| VT | — | $94.10 | — |
| WA | — | $111.21 | — |
| WI | — | $99.43 | — |
| WV | — | $94.10 | — |
| WY | — | $121.93 | — |
How the L2220 fee compares
| Measure | Value |
|---|---|
| Rank among 12 L22 codes (lowest = 1) | 5 |
| Family fee range (average of state fees) | $64.40–$580.99 |
| Rural fee uplift | — |
Who bills L2220 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 1,226 |
| Referring clinicians | 3,288 |
| Medicare beneficiaries | 3,857 |
| States with claims | 43 |
| Share of services in top 3 states (California, New York, Pennsylvania) | 32% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1,351 | 4,095 |
| 2023 | 1,318 | 4,084 |
| 2024 | 1,226 | 3,857 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L2220, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 8,786 | 4,095 | $89.89 | $69.84 |
| 2023 | 8,715 | 4,084 | $96.92 | $75.00 |
| 2024 | 8,266 | 3,857 | $100.76 | $77.81 |
States with the most L2220 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 1,163 | $92.69 |
| New York | 802 | $78.58 |
| Pennsylvania | 654 | $69.25 |
| Texas | 354 | $74.50 |
| Florida | 340 | $75.78 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 4 | Anatomic Consideration |
| outpatient hospital claims | 4 | 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 L2220
- 2026-01-01: Average state fee rose 2.0%: $104.81 to $106.91
- 1986-01-01: L2220 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 L2220?
L2220 is the HCPCS Level II code for addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint. Short descriptor: "Dorsi & plantar flex ass/res".
How much does Medicare pay for L2220?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $94.10–$196.92. Rural fees can be higher.
Does Medicare cover L2220?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L2220?
Medicare policy articles that cite L2220 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 L2220 change in 2026?
The average non-rural state fee moved from $104.81 in 2025 to $106.91 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2220 can be billed per day?
4 on DME suppliers; 4 on outpatient hospital claims (NCCI medically unlikely edits).
Related L22 codes
- L2200 — Addition to lower extremity, limited ankle motion, each joint ($54.63–$132.78)
- L2210 — Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint ($66.65–$164.31)
- L2230 — Addition to lower extremity, split flat caliper stirrups and plate attachment ($51.03–$220.94)
- L2232 — Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only ($119.38–$119.38)
- L2240 — Addition to lower extremity, round caliper and plate attachment ($25.45–$219.49)
- L2250 — Addition to lower extremity, foot plate, molded to patient model, stirrup attachment ($348.31–$972.13)
- L2260 — Addition to lower extremity, reinforced solid stirrup (scott-craig type) ($230.35–$839.25)
- L2265 — Addition to lower extremity, long tongue stirrup ($135.33–$352.26)
- L2270 — Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad ($61.71–$161.82)
- L2275 — Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined ($144.84–$212.26)
- L2280 — Addition to lower extremity, molded inner boot ($520.33–$865.99)
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 L2220
- Watch L2220 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2220
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.