L2800 HCPCS code: Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only
L2800 is the HCPCS Level II code for addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only. The 2026 Medicare DMEPOS fee schedule pays $104.71 to $215.66 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. Its average fee ranks 6 of 6 L28 codes (family range $56.40–$138.30).
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 | 2005-01-01 |
2026 Medicare DMEPOS fee schedule for L2800
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $104.71 | $215.66 | $163.43 | $122.57 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $201.67 | — |
| AL | — | $122.57 | — |
| AR | — | $122.57 | — |
| AZ | — | $163.43 | — |
| CA | — | $163.43 | — |
| CO | — | $134.44 | — |
| CT | — | $163.43 | — |
| DC | — | $152.45 | — |
| DE | — | $152.45 | — |
| FL | — | $122.57 | — |
| GA | — | $122.57 | — |
| HI | — | $215.66 | — |
| IA | — | $122.57 | — |
| ID | — | $140.51 | — |
| IL | — | $123.76 | — |
| IN | — | $123.76 | — |
| KS | — | $122.57 | — |
| KY | — | $122.57 | — |
| LA | — | $122.57 | — |
| MA | — | $163.43 | — |
| MD | — | $152.45 | — |
| ME | — | $163.43 | — |
| MI | — | $123.76 | — |
| MN | — | $123.76 | — |
| MO | — | $122.57 | — |
| MS | — | $122.57 | — |
| MT | — | $134.44 | — |
| NC | — | $122.57 | — |
| ND | — | $134.44 | — |
| NE | — | $122.57 | — |
| NH | — | $163.43 | — |
| NJ | — | $122.57 | — |
| NM | — | $122.57 | — |
| NV | — | $163.43 | — |
| NY | — | $122.57 | — |
| OH | — | $123.76 | — |
| OK | — | $122.57 | — |
| OR | — | $140.51 | — |
| PA | — | $152.45 | — |
| PR | — | $104.71 | — |
| RI | — | $163.43 | — |
| SC | — | $122.57 | — |
| SD | — | $134.44 | — |
| TN | — | $122.57 | — |
| TX | — | $122.57 | — |
| UT | — | $134.44 | — |
| VA | — | $152.45 | — |
| VI | — | $122.57 | — |
| VT | — | $163.43 | — |
| WA | — | $140.51 | — |
| WI | — | $123.76 | — |
| WV | — | $152.45 | — |
| WY | — | $134.44 | — |
How the L2800 fee compares
| Measure | Value |
|---|---|
| Rank among 6 L28 codes (lowest = 1) | 6 |
| Family fee range (average of state fees) | $56.40–$138.30 |
| Rural fee uplift | — |
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 L2800
- 2026-01-01: Average state fee rose 2.0%: $135.59 to $138.30
- 1988-01-01: L2800 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 L2800?
L2800 is the HCPCS Level II code for addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only. Short descriptor: "Knee cap medial or lateral p".
How much does Medicare pay for L2800?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $104.71–$215.66. Rural fees can be higher.
Does Medicare cover L2800?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L2800 change in 2026?
The average non-rural state fee moved from $135.59 in 2025 to $138.30 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2800 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L28 codes
- L2810 — Addition to lower extremity orthosis, knee control, condylar pad ($85.68–$173.70)
- L2820 — Addition to lower extremity orthosis, soft interface for molded plastic, below knee section ($99.79–$399.72)
- L2830 — Addition to lower extremity orthosis, soft interface for molded plastic, above knee section ($107.96–$399.72)
- L2840 — Addition to lower extremity orthosis, tibial length sock, fracture or equal, each ($50.21–$66.94)
- L2850 — Addition to lower extremity orthosis, femoral length sock, fracture or equal, each ($71.15–$94.86)
- L2861 — Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each
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Next steps
- Run a reimbursement report for a device billed under L2800
- Watch L2800 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2800
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.