L2395 HCPCS code: Addition to lower extremity, offset knee joint, heavy duty, each joint
L2395 is the HCPCS Level II code for addition to lower extremity, offset knee joint, heavy duty, each joint. The 2026 Medicare DMEPOS fee schedule pays $76.15 to $251.19 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 51% from 2022 to 2024 (823 to 400 services). In 2024, 120 suppliers billed Medicare for L2395 (purchases), serving 256 beneficiaries. Its average fee ranks 8 of 16 L23 codes (family range $67.64–$1,175.80).
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 |
2026 Medicare DMEPOS fee schedule for L2395
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $76.15 | $251.19 | $239.73 | $179.80 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $234.95 | — |
| AL | — | $192.05 | — |
| AR | — | $239.73 | — |
| AZ | — | $219.72 | — |
| CA | — | $219.72 | — |
| CO | — | $213.62 | — |
| CT | — | $239.73 | — |
| DC | — | $179.80 | — |
| DE | — | $179.80 | — |
| FL | — | $192.05 | — |
| GA | — | $192.05 | — |
| HI | — | $251.19 | — |
| IA | — | $189.17 | — |
| ID | — | $179.80 | — |
| IL | — | $179.80 | — |
| IN | — | $179.80 | — |
| KS | — | $189.17 | — |
| KY | — | $192.05 | — |
| LA | — | $239.73 | — |
| MA | — | $239.73 | — |
| MD | — | $179.80 | — |
| ME | — | $239.73 | — |
| MI | — | $179.80 | — |
| MN | — | $179.80 | — |
| MO | — | $189.17 | — |
| MS | — | $192.05 | — |
| MT | — | $213.62 | — |
| NC | — | $192.05 | — |
| ND | — | $213.62 | — |
| NE | — | $189.17 | — |
| NH | — | $239.73 | — |
| NJ | — | $179.80 | — |
| NM | — | $239.73 | — |
| NV | — | $219.72 | — |
| NY | — | $179.80 | — |
| OH | — | $179.80 | — |
| OK | — | $239.73 | — |
| OR | — | $179.80 | — |
| PA | — | $179.80 | — |
| PR | — | $76.15 | — |
| RI | — | $239.73 | — |
| SC | — | $192.05 | — |
| SD | — | $213.62 | — |
| TN | — | $192.05 | — |
| TX | — | $239.73 | — |
| UT | — | $213.62 | — |
| VA | — | $179.80 | — |
| VI | — | $179.80 | — |
| VT | — | $239.73 | — |
| WA | — | $179.80 | — |
| WI | — | $179.80 | — |
| WV | — | $179.80 | — |
| WY | — | $213.62 | — |
How the L2395 fee compares
| Measure | Value |
|---|---|
| Rank among 16 L23 codes (lowest = 1) | 8 |
| Family fee range (average of state fees) | $67.64–$1,175.80 |
| Rural fee uplift | — |
Who bills L2395 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 120 |
| Referring clinicians | 140 |
| Medicare beneficiaries | 256 |
| States with claims | 4 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 126 | 439 |
| 2023 | 126 | 289 |
| 2024 | 120 | 256 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L2395, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 823 | 439 | $163.48 | $127.85 |
| 2023 | 505 | 289 | $183.69 | $143.50 |
| 2024 | 400 | 256 | $198.04 | $155.07 |
States with the most L2395 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Arizona | 155 | $164.24 |
| California | 25 | $164.92 |
| New York | 24 | $139.95 |
| Texas | 21 | $170.52 |
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
- A52465: Knee Orthoses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (4,806 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| G04.1 | Tropical spastic paraplegia | 1 |
| G35.A | Relapsing-remitting multiple sclerosis | 1 |
| G35.B0 | Primary progressive multiple sclerosis, unspecified | 1 |
| G35.B1 | Active primary progressive multiple sclerosis | 1 |
| G35.B2 | Non-active primary progressive multiple sclerosis | 1 |
| G35.C0 | Secondary progressive multiple sclerosis, unspecified | 1 |
| G35.C1 | Active secondary progressive multiple sclerosis | 1 |
| G35.C2 | Non-active secondary progressive multiple sclerosis | 1 |
| G35.D | Multiple sclerosis, unspecified | 1 |
| G57.01 | Lesion of sciatic nerve, right lower limb | 1 |
Showing 10 of 4,806. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L2395
- 2026-01-01: Average state fee rose 2.0%: $197.36 to $201.31
- 1988-01-01: L2395 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 L2395?
L2395 is the HCPCS Level II code for addition to lower extremity, offset knee joint, heavy duty, each joint. Short descriptor: "Offset knee joint heavy duty".
How much does Medicare pay for L2395?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $76.15–$251.19. Rural fees can be higher.
Does Medicare cover L2395?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L2395?
Medicare policy articles that cite L2395 list 4,806 covered ICD-10-CM diagnosis codes across 1 article. The most cited include G04.1 (Tropical spastic paraplegia), G35.A (Relapsing-remitting multiple sclerosis), G35.B0 (Primary progressive multiple sclerosis, unspecified). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for L2395 change in 2026?
The average non-rural state fee moved from $197.36 in 2025 to $201.31 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2395 can be billed per day?
4 on DME suppliers; 4 on outpatient hospital claims (NCCI medically unlikely edits).
Related L23 codes
- L2300 — Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable ($61.30–$642.91)
- L2310 — Addition to lower extremity, abduction bar-straight ($61.30–$340.87)
- L2320 — Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only ($236.44–$325.94)
- L2330 — Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only ($429.42–$904.14)
- L2335 — Addition to lower extremity, anterior swing band ($142.76–$463.43)
- L2340 — Addition to lower extremity, pre-tibial shell, molded to patient model ($513.58–$767.22)
- L2350 — Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses) ($1,023.92–$2,531.61)
- L2360 — Addition to lower extremity, extended steel shank ($59.45–$96.81)
- L2370 — Addition to lower extremity, patten bottom ($294.98–$719.55)
- L2375 — Addition to lower extremity, torsion control, ankle joint and half solid stirrup ($85.68–$206.12)
- L2380 — Addition to lower extremity, torsion control, straight knee joint, each joint ($57.10–$243.39)
- L2385 — Addition to lower extremity, straight knee joint, heavy duty, each joint ($51.03–$225.93)
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 L2395
- Watch L2395 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2395
Sources: CMS HCPCS Level II release October 2026; 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.