L2232 HCPCS code: Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only
L2232 is the HCPCS Level II code for addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only. The 2026 Medicare DMEPOS fee schedule pays $119.38 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 rose 19% from 2022 to 2024 (777 to 927 services). In 2024, 396 suppliers billed Medicare for L2232 (purchases), serving 797 beneficiaries; Texas, Georgia, California accounted for 32% of services. Its average fee ranks 7 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 | 2005-01-01 |
| Last action effective | 2005-01-01 |
2026 Medicare DMEPOS fee schedule for L2232
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $119.38 | $119.38 | $143.26 | $107.44 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $119.38 | — |
| AL | — | $119.38 | — |
| AR | — | $119.38 | — |
| AZ | — | $119.38 | — |
| CA | — | $119.38 | — |
| CO | — | $119.38 | — |
| CT | — | $119.38 | — |
| DC | — | $119.38 | — |
| DE | — | $119.38 | — |
| FL | — | $119.38 | — |
| GA | — | $119.38 | — |
| HI | — | $119.38 | — |
| IA | — | $119.38 | — |
| ID | — | $119.38 | — |
| IL | — | $119.38 | — |
| IN | — | $119.38 | — |
| KS | — | $119.38 | — |
| KY | — | $119.38 | — |
| LA | — | $119.38 | — |
| MA | — | $119.38 | — |
| MD | — | $119.38 | — |
| ME | — | $119.38 | — |
| MI | — | $119.38 | — |
| MN | — | $119.38 | — |
| MO | — | $119.38 | — |
| MS | — | $119.38 | — |
| MT | — | $119.38 | — |
| NC | — | $119.38 | — |
| ND | — | $119.38 | — |
| NE | — | $119.38 | — |
| NH | — | $119.38 | — |
| NJ | — | $119.38 | — |
| NM | — | $119.38 | — |
| NV | — | $119.38 | — |
| NY | — | $119.38 | — |
| OH | — | $119.38 | — |
| OK | — | $119.38 | — |
| OR | — | $119.38 | — |
| PA | — | $119.38 | — |
| PR | — | $119.38 | — |
| RI | — | $119.38 | — |
| SC | — | $119.38 | — |
| SD | — | $119.38 | — |
| TN | — | $119.38 | — |
| TX | — | $119.38 | — |
| UT | — | $119.38 | — |
| VA | — | $119.38 | — |
| VI | — | $119.38 | — |
| VT | — | $119.38 | — |
| WA | — | $119.38 | — |
| WI | — | $119.38 | — |
| WV | — | $119.38 | — |
| WY | — | $119.38 | — |
How the L2232 fee compares
| Measure | Value |
|---|---|
| Rank among 12 L22 codes (lowest = 1) | 7 |
| Family fee range (average of state fees) | $64.40–$580.99 |
| Rural fee uplift | — |
Who bills L2232 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 396 |
| Referring clinicians | 702 |
| Medicare beneficiaries | 797 |
| States with claims | 25 |
| Share of services in top 3 states (Texas, Georgia, California) | 32% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 383 | 682 |
| 2023 | 410 | 752 |
| 2024 | 396 | 797 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L2232, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 777 | 682 | $101.93 | $79.51 |
| 2023 | 870 | 752 | $111.24 | $85.72 |
| 2024 | 927 | 797 | $114.11 | $86.85 |
States with the most L2232 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 98 | $84.64 |
| Georgia | 82 | $84.87 |
| California | 80 | $88.89 |
| Minnesota | 54 | $84.01 |
| Illinois | 47 | $89.61 |
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 L2232
- 2026-01-01: Average state fee rose 2.0%: $117.04 to $119.38
- 2005-01-01: L2232 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 L2232?
L2232 is the HCPCS Level II code for addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only. Short descriptor: "Rocker bottom, contact afo".
How much does Medicare pay for L2232?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $119.38. Rural fees can be higher.
Does Medicare cover L2232?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L2232 change in 2026?
The average non-rural state fee moved from $117.04 in 2025 to $119.38 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2232 can be billed per day?
2 on DME suppliers; 2 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)
- L2220 — Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint ($94.10–$196.92)
- L2230 — Addition to lower extremity, split flat caliper stirrups and plate attachment ($51.03–$220.94)
- 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 L2232
- Watch L2232 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2232
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.