L2820 HCPCS code: Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
L2820 is the HCPCS Level II code for addition to lower extremity orthosis, soft interface for molded plastic, below knee section. The 2026 Medicare DMEPOS fee schedule pays $99.79 to $399.72 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 fell 14% from 2022 to 2024 (48,221 to 41,345 services). In 2024, 3,433 suppliers billed Medicare for L2820 (purchases), serving 33,671 beneficiaries; California, New York, Florida accounted for 22% of services. Its average fee ranks 4 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 | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L2820
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $99.79 | $399.72 | $133.05 | $99.79 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $242.74 | — |
| AL | — | $99.79 | — |
| AR | — | $99.79 | — |
| AZ | — | $133.05 | — |
| CA | — | $133.05 | — |
| CO | — | $133.05 | — |
| CT | — | $132.53 | — |
| DC | — | $99.79 | — |
| DE | — | $99.79 | — |
| FL | — | $99.79 | — |
| GA | — | $99.79 | — |
| HI | — | $259.59 | — |
| IA | — | $99.79 | — |
| ID | — | $99.79 | — |
| IL | — | $99.79 | — |
| IN | — | $99.79 | — |
| KS | — | $99.79 | — |
| KY | — | $99.79 | — |
| LA | — | $99.79 | — |
| MA | — | $132.53 | — |
| MD | — | $99.79 | — |
| ME | — | $132.53 | — |
| MI | — | $99.79 | — |
| MN | — | $99.79 | — |
| MO | — | $99.79 | — |
| MS | — | $99.79 | — |
| MT | — | $133.05 | — |
| NC | — | $99.79 | — |
| ND | — | $133.05 | — |
| NE | — | $99.79 | — |
| NH | — | $132.53 | — |
| NJ | — | $114.60 | — |
| NM | — | $99.79 | — |
| NV | — | $133.05 | — |
| NY | — | $114.60 | — |
| OH | — | $99.79 | — |
| OK | — | $99.79 | — |
| OR | — | $99.79 | — |
| PA | — | $99.79 | — |
| PR | — | $399.72 | — |
| RI | — | $132.53 | — |
| SC | — | $99.79 | — |
| SD | — | $133.05 | — |
| TN | — | $99.79 | — |
| TX | — | $99.79 | — |
| UT | — | $133.05 | — |
| VA | — | $99.79 | — |
| VI | — | $114.60 | — |
| VT | — | $132.53 | — |
| WA | — | $99.79 | — |
| WI | — | $99.79 | — |
| WV | — | $99.79 | — |
| WY | — | $133.05 | — |
How the L2820 fee compares
| Measure | Value |
|---|---|
| Rank among 6 L28 codes (lowest = 1) | 4 |
| Family fee range (average of state fees) | $56.40–$138.30 |
| Rural fee uplift | — |
Who bills L2820 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 3,433 |
| Referring clinicians | 19,313 |
| Medicare beneficiaries | 33,671 |
| States with claims | 51 |
| Share of services in top 3 states (California, New York, Florida) | 22% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 3,921 | 38,429 |
| 2023 | 3,669 | 35,777 |
| 2024 | 3,433 | 33,671 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L2820, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 48,221 | 38,429 | $94.08 | $73.32 |
| 2023 | 44,072 | 35,777 | $102.17 | $78.94 |
| 2024 | 41,345 | 33,671 | $105.23 | $81.28 |
States with the most L2820 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 4,492 | $97.93 |
| New York | 2,349 | $84.62 |
| Florida | 2,286 | $74.05 |
| Texas | 2,036 | $73.92 |
| Illinois | 1,982 | $74.51 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
Medicare policy articles for this code
- A52457: Ankle-Foot/Knee-Ankle-Foot Orthoses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- 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 (4,818 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A52.16 | Charcot's arthropathy (tabetic) | 1 |
| E08.610 | Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy | 1 |
| E09.610 | Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy | 1 |
| E10.610 | Type 1 diabetes mellitus with diabetic neuropathic arthropathy | 1 |
| E11.610 | Type 2 diabetes mellitus with diabetic neuropathic arthropathy | 1 |
| 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 |
Showing 10 of 4,818. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L2820
- 2026-01-01: Average state fee rose 2.0%: $118.97 to $121.35
- 1988-01-01: L2820 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 L2820?
L2820 is the HCPCS Level II code for addition to lower extremity orthosis, soft interface for molded plastic, below knee section. Short descriptor: "Soft interface below knee se".
How much does Medicare pay for L2820?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $99.79–$399.72. Rural fees can be higher.
Does Medicare cover L2820?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L2820?
Medicare policy articles that cite L2820 list 4,818 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include A52.16 (Charcot's arthropathy (tabetic)), E08.610 (Diabetes mellitus due to underlying condition with diabetic neuropathic arthropathy), E09.610 (Drug or chemical induced diabetes mellitus with diabetic neuropathic arthropathy). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for L2820 change in 2026?
The average non-rural state fee moved from $118.97 in 2025 to $121.35 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L2820 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L28 codes
- L2800 — Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only ($104.71–$215.66)
- L2810 — Addition to lower extremity orthosis, knee control, condylar pad ($85.68–$173.70)
- 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
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 L2820
- Watch L2820 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2820
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.