L2397 HCPCS code: Addition to lower extremity orthosis, suspension sleeve
L2397 is the HCPCS Level II code for addition to lower extremity orthosis, suspension sleeve. The 2026 Medicare DMEPOS fee schedule pays $134.68 to $165.97 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 rose 42% from 2022 to 2024 (103,729 to 147,375 services). In 2024, 1,009 suppliers billed Medicare for L2397 (purchases), serving 81,079 beneficiaries; New York, California, Texas accounted for 27% of services. Its average fee ranks 3 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 | 1994-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L2397
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $134.68 | $165.97 | $172.19 | $129.14 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $144.60 | — |
| AL | — | $134.68 | — |
| AR | — | $134.68 | — |
| AZ | — | $151.86 | — |
| CA | — | $151.86 | — |
| CO | — | $147.97 | — |
| CT | — | $141.69 | — |
| DC | — | $140.07 | — |
| DE | — | $140.07 | — |
| FL | — | $134.68 | — |
| GA | — | $134.68 | — |
| HI | — | $144.60 | — |
| IA | — | $154.84 | — |
| ID | — | $151.86 | — |
| IL | — | $150.00 | — |
| IN | — | $150.00 | — |
| KS | — | $154.84 | — |
| KY | — | $134.68 | — |
| LA | — | $134.68 | — |
| MA | — | $141.69 | — |
| MD | — | $140.07 | — |
| ME | — | $141.69 | — |
| MI | — | $150.00 | — |
| MN | — | $150.00 | — |
| MO | — | $154.84 | — |
| MS | — | $134.68 | — |
| MT | — | $147.97 | — |
| NC | — | $134.68 | — |
| ND | — | $147.97 | — |
| NE | — | $154.84 | — |
| NH | — | $141.69 | — |
| NJ | — | $135.65 | — |
| NM | — | $134.68 | — |
| NV | — | $151.86 | — |
| NY | — | $135.65 | — |
| OH | — | $150.00 | — |
| OK | — | $134.68 | — |
| OR | — | $151.86 | — |
| PA | — | $140.07 | — |
| PR | — | $165.97 | — |
| RI | — | $141.69 | — |
| SC | — | $134.68 | — |
| SD | — | $147.97 | — |
| TN | — | $134.68 | — |
| TX | — | $134.68 | — |
| UT | — | $147.97 | — |
| VA | — | $140.07 | — |
| VI | — | $135.65 | — |
| VT | — | $141.69 | — |
| WA | — | $151.86 | — |
| WI | — | $150.00 | — |
| WV | — | $140.07 | — |
| WY | — | $147.97 | — |
How the L2397 fee compares
| Measure | Value |
|---|---|
| Rank among 16 L23 codes (lowest = 1) | 3 |
| Family fee range (average of state fees) | $67.64–$1,175.80 |
| Rural fee uplift | — |
Who bills L2397 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 1,009 |
| Referring clinicians | 32,576 |
| Medicare beneficiaries | 81,079 |
| States with claims | 52 |
| Share of services in top 3 states (New York, California, Texas) | 27% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1,229 | 58,960 |
| 2023 | 1,082 | 60,052 |
| 2024 | 1,009 | 81,079 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L2397, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 103,729 | 58,960 | $122.33 | $96.10 |
| 2023 | 107,031 | 60,052 | $131.78 | $102.93 |
| 2024 | 147,375 | 81,079 | $135.15 | $105.64 |
States with the most L2397 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 13,731 | $102.11 |
| California | 13,507 | $112.86 |
| Texas | 12,469 | $101.37 |
| Florida | 8,831 | $100.93 |
| Virginia | 5,910 | $104.39 |
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 L2397
- 2026-01-01: Average state fee rose 2.0%: $140.99 to $143.81
- 1994-01-01: L2397 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 L2397?
L2397 is the HCPCS Level II code for addition to lower extremity orthosis, suspension sleeve. Short descriptor: "Suspension sleeve lower ext".
How much does Medicare pay for L2397?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $134.68–$165.97. Rural fees can be higher.
Does Medicare cover L2397?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L2397?
Medicare policy articles that cite L2397 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 L2397 change in 2026?
The average non-rural state fee moved from $140.99 in 2025 to $143.81 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2397 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 L2397
- Watch L2397 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2397
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.