L4002 HCPCS code: Replacement strap, any orthosis, includes all components, any length, any type
L4002 is the HCPCS Level II code for replacement strap, any orthosis, includes all components, any length, any type. In 2024 Medicare paid an average of $20.49 per service for L4002 across 8,740 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 8 per day on DME suppliers. Medicare volume fell 19% from 2022 to 2024 (10,761 to 8,740 services). In 2024, 687 suppliers billed Medicare for L4002 (purchases), serving 3,356 beneficiaries; Minnesota, New York, Massachusetts accounted for 31% of services.
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 | 2005-01-01 |
| Last action effective | 2005-01-01 |
Who bills L4002 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 687 |
| Referring clinicians | 2,884 |
| Medicare beneficiaries | 3,356 |
| States with claims | 43 |
| Share of services in top 3 states (Minnesota, New York, Massachusetts) | 31% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 797 | 4,119 |
| 2023 | 746 | 3,781 |
| 2024 | 687 | 3,356 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L4002, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 10,761 | 4,119 | $22.78 | $16.28 |
| 2023 | 9,879 | 3,781 | $24.87 | $17.69 |
| 2024 | 8,740 | 3,356 | $28.69 | $20.49 |
States with the most L4002 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Minnesota | 1,095 | $16.12 |
| New York | 957 | $21.27 |
| Massachusetts | 639 | $18.45 |
| California | 480 | $23.15 |
| Michigan | 437 | $16.18 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 8 | Clinical: Data |
| outpatient hospital claims | 4 | Clinical: Data |
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 L4002
- 2005-01-01: L4002 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 L4002?
L4002 is the HCPCS Level II code for replacement strap, any orthosis, includes all components, any length, any type. Short descriptor: "Replace strap, any orthosis".
How much does Medicare pay for L4002?
In 2024, the average Medicare payment was $20.49 per service (average allowed $28.69).
Does Medicare cover L4002?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L4002?
Medicare policy articles that cite L4002 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.
How many units of L4002 can be billed per day?
8 on DME suppliers; 4 on outpatient hospital claims (NCCI medically unlikely edits).
Related L40 codes
- L4000 — Replace girdle for spinal orthosis (ctlso or so) ($1,332.49–$2,202.71)
- L4010 — Replace trilateral socket brim ($771.19–$1,290.07)
- L4020 — Replace quadrilateral socket brim, molded to patient model ($989.77–$1,433.34)
- L4030 — Replace quadrilateral socket brim, custom fitted ($580.17–$1,142.13)
- L4040 — Replace molded thigh lacer, for custom fabricated orthosis only ($469.07–$1,370.51)
- L4045 — Replace non-molded thigh lacer, for custom fabricated orthosis only ($376.94–$738.06)
- L4050 — Replace molded calf lacer, for custom fabricated orthosis only ($474.40–$1,142.13)
- L4055 — Replace non-molded calf lacer, for custom fabricated orthosis only ($307.20–$686.22)
- L4060 — Replace high roll cuff ($304.58–$689.86)
- L4070 — Replace proximal and distal upright for kafo ($304.58–$949.20)
- L4080 — Replace metal bands kafo, proximal thigh ($116.23–$154.98)
- L4090 — Replace metal bands kafo-afo, calf or distal thigh ($103.77–$142.76)
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 L4002
- Watch L4002 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L4002
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; 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.