L2525 HCPCS code: Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model
L2525 is the HCPCS Level II code for addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model. The 2026 Medicare DMEPOS fee schedule pays $1,400.77 to $1,889.47 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 9% from 2022 to 2024 (135 to 147 services). In 2024, 80 suppliers billed Medicare for L2525 (purchases), serving 130 beneficiaries. Its average fee ranks 10 of 10 L25 codes (family range $311.28–$1,613.00).
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 | 1989-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L2525
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1,400.77 | $1,889.47 | $1,867.69 | $1,400.77 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $1,766.99 | — |
| AL | — | $1,816.17 | — |
| AR | — | $1,400.77 | — |
| AZ | — | $1,743.48 | — |
| CA | — | $1,743.48 | — |
| CO | — | $1,574.97 | — |
| CT | — | $1,867.69 | — |
| DC | — | $1,491.28 | — |
| DE | — | $1,491.28 | — |
| FL | — | $1,816.17 | — |
| GA | — | $1,816.17 | — |
| HI | — | $1,889.47 | — |
| IA | — | $1,534.58 | — |
| ID | — | $1,491.12 | — |
| IL | — | $1,400.77 | — |
| IN | — | $1,400.77 | — |
| KS | — | $1,534.58 | — |
| KY | — | $1,816.17 | — |
| LA | — | $1,400.77 | — |
| MA | — | $1,867.69 | — |
| MD | — | $1,491.28 | — |
| ME | — | $1,867.69 | — |
| MI | — | $1,400.77 | — |
| MN | — | $1,400.77 | — |
| MO | — | $1,534.58 | — |
| MS | — | $1,816.17 | — |
| MT | — | $1,574.97 | — |
| NC | — | $1,816.17 | — |
| ND | — | $1,574.97 | — |
| NE | — | $1,534.58 | — |
| NH | — | $1,867.69 | — |
| NJ | — | $1,612.22 | — |
| NM | — | $1,400.77 | — |
| NV | — | $1,743.48 | — |
| NY | — | $1,612.22 | — |
| OH | — | $1,400.77 | — |
| OK | — | $1,400.77 | — |
| OR | — | $1,491.12 | — |
| PA | — | $1,491.28 | — |
| PR | — | $1,612.11 | — |
| RI | — | $1,867.69 | — |
| SC | — | $1,816.17 | — |
| SD | — | $1,574.97 | — |
| TN | — | $1,816.17 | — |
| TX | — | $1,400.77 | — |
| UT | — | $1,574.97 | — |
| VA | — | $1,491.28 | — |
| VI | — | $1,612.22 | — |
| VT | — | $1,867.69 | — |
| WA | — | $1,491.12 | — |
| WI | — | $1,400.77 | — |
| WV | — | $1,491.28 | — |
| WY | — | $1,574.97 | — |
How the L2525 fee compares
| Measure | Value |
|---|---|
| Rank among 10 L25 codes (lowest = 1) | 10 |
| Family fee range (average of state fees) | $311.28–$1,613.00 |
| Rural fee uplift | — |
Who bills L2525 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 80 |
| Referring clinicians | 122 |
| Medicare beneficiaries | 130 |
| States with claims | 2 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 76 | 121 |
| 2023 | 70 | 147 |
| 2024 | 80 | 130 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L2525, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 135 | 121 | $1,391.17 | $1,088.17 |
| 2023 | 170 | 147 | $1,509.67 | $1,183.58 |
| 2024 | 147 | 130 | $1,558.36 | $1,206.40 |
States with the most L2525 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 45 | $1,279.88 |
| New York | 26 | $1,212.81 |
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 L2525
- 2026-01-01: Average state fee rose 2.0%: $1,581.37 to $1,613.00
- 1989-01-01: L2525 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 L2525?
L2525 is the HCPCS Level II code for addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model. Short descriptor: "Th/wght bear nar m-l brim mo".
How much does Medicare pay for L2525?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,400.77–$1,889.47. Rural fees can be higher.
Does Medicare cover L2525?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L2525 change in 2026?
The average non-rural state fee moved from $1,581.37 in 2025 to $1,613.00 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2525 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L25 codes
- L2500 — Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring ($225.00–$563.67)
- L2510 — Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model ($834.70–$1,431.47)
- L2520 — Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted ($529.38–$856.60)
- L2526 — Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted ($787.09–$2,284.23)
- L2530 — Addition to lower extremity, thigh-weight bearing, lacer, non-molded ($269.99–$550.35)
- L2540 — Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model ($485.83–$901.89)
- L2550 — Addition to lower extremity, thigh/weight bearing, high roll cuff ($142.76–$608.48)
- L2570 — Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each ($511.24–$1,207.51)
- L2580 — Addition to lower extremity, pelvic control, pelvic sling ($533.32–$906.36)
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 L2525
- Watch L2525 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2525
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.