L2425 HCPCS code: Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint
L2425 is the HCPCS Level II code for addition to knee joint, disc or dial lock for adjustable knee flexion, each joint. The 2026 Medicare DMEPOS fee schedule pays $171.93 to $189.18 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. Its average fee ranks 4 of 5 L24 codes (family range $106.61–$175.29).
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 | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L2425
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $171.93 | $189.18 | $209.83 | $157.37 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $171.93 | — |
| AL | — | $177.12 | — |
| AR | — | $177.11 | — |
| AZ | — | $171.93 | — |
| CA | — | $171.93 | — |
| CO | — | $178.12 | — |
| CT | — | $171.93 | — |
| DC | — | $171.93 | — |
| DE | — | $171.93 | — |
| FL | — | $177.12 | — |
| GA | — | $177.12 | — |
| HI | — | $171.93 | — |
| IA | — | $175.28 | — |
| ID | — | $171.93 | — |
| IL | — | $176.17 | — |
| IN | — | $176.17 | — |
| KS | — | $175.28 | — |
| KY | — | $177.12 | — |
| LA | — | $177.11 | — |
| MA | — | $171.93 | — |
| MD | — | $171.93 | — |
| ME | — | $171.93 | — |
| MI | — | $176.17 | — |
| MN | — | $176.17 | — |
| MO | — | $175.28 | — |
| MS | — | $177.12 | — |
| MT | — | $178.12 | — |
| NC | — | $177.12 | — |
| ND | — | $178.12 | — |
| NE | — | $175.28 | — |
| NH | — | $171.93 | — |
| NJ | — | $171.93 | — |
| NM | — | $177.11 | — |
| NV | — | $171.93 | — |
| NY | — | $171.93 | — |
| OH | — | $176.17 | — |
| OK | — | $177.11 | — |
| OR | — | $171.93 | — |
| PA | — | $171.93 | — |
| PR | — | $189.18 | — |
| RI | — | $171.93 | — |
| SC | — | $177.12 | — |
| SD | — | $178.12 | — |
| TN | — | $177.12 | — |
| TX | — | $177.11 | — |
| UT | — | $178.12 | — |
| VA | — | $171.93 | — |
| VI | — | $189.18 | — |
| VT | — | $171.93 | — |
| WA | — | $171.93 | — |
| WI | — | $176.17 | — |
| WV | — | $171.93 | — |
| WY | — | $178.12 | — |
How the L2425 fee compares
| Measure | Value |
|---|---|
| Rank among 5 L24 codes (lowest = 1) | 4 |
| Family fee range (average of state fees) | $106.61–$175.29 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 4 | Anatomic Consideration |
| outpatient hospital claims | 4 | Anatomic Consideration |
What changed for L2425
- 2026-01-01: Average state fee rose 2.0%: $171.85 to $175.29
- 1988-01-01: L2425 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 L2425?
L2425 is the HCPCS Level II code for addition to knee joint, disc or dial lock for adjustable knee flexion, each joint. Short descriptor: "Knee disc/dial lock/adj flex".
How much does Medicare pay for L2425?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $171.93–$189.18. Rural fees can be higher.
Does Medicare cover L2425?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L2425 change in 2026?
The average non-rural state fee moved from $171.85 in 2025 to $175.29 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2425 can be billed per day?
4 on DME suppliers; 4 on outpatient hospital claims (NCCI medically unlikely edits).
Related L24 codes
- L2405 — Addition to knee joint, drop lock, each ($104.57–$115.02)
- L2415 — Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint ($145.69–$160.30)
- L2430 — Addition to knee joint, ratchet lock for active and progressive knee extension, each joint ($171.93–$189.18)
- L2492 — Addition to knee joint, lift loop for drop lock ring ($117.18–$156.11)
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Next steps
- Run a reimbursement report for a device billed under L2425
- Watch L2425 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2425
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.