L4050 HCPCS code: Replace molded calf lacer, for custom fabricated orthosis only
L4050 is the HCPCS Level II code for replace molded calf lacer, for custom fabricated orthosis only. The 2026 Medicare DMEPOS fee schedule pays $474.40 to $1,142.13 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 10% from 2022 to 2024 (21 to 19 services). In 2024, 13 suppliers billed Medicare for L4050 (purchases), serving 16 beneficiaries. Its average fee ranks 8 of 12 L40 codes (family range $117.32–$1,638.51).
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 | 1985-01-01 |
| Last action effective | 2005-01-01 |
2026 Medicare DMEPOS fee schedule for L4050
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $474.40 | $1,142.13 | $632.54 | $474.40 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $1,009.80 | — |
| AL | — | $474.40 | — |
| AR | — | $474.40 | — |
| AZ | — | $632.54 | — |
| CA | — | $632.54 | — |
| CO | — | $474.40 | — |
| CT | — | $577.81 | — |
| DC | — | $474.40 | — |
| DE | — | $474.40 | — |
| FL | — | $474.40 | — |
| GA | — | $474.40 | — |
| HI | — | $1,079.79 | — |
| IA | — | $535.47 | — |
| ID | — | $571.58 | — |
| IL | — | $505.37 | — |
| IN | — | $505.37 | — |
| KS | — | $535.47 | — |
| KY | — | $474.40 | — |
| LA | — | $474.40 | — |
| MA | — | $577.81 | — |
| MD | — | $474.40 | — |
| ME | — | $577.81 | — |
| MI | — | $505.37 | — |
| MN | — | $505.37 | — |
| MO | — | $535.47 | — |
| MS | — | $474.40 | — |
| MT | — | $474.40 | — |
| NC | — | $474.40 | — |
| ND | — | $474.40 | — |
| NE | — | $535.47 | — |
| NH | — | $577.81 | — |
| NJ | — | $632.54 | — |
| NM | — | $474.40 | — |
| NV | — | $632.54 | — |
| NY | — | $632.54 | — |
| OH | — | $505.37 | — |
| OK | — | $474.40 | — |
| OR | — | $571.58 | — |
| PA | — | $474.40 | — |
| PR | — | $1,142.13 | — |
| RI | — | $577.81 | — |
| SC | — | $474.40 | — |
| SD | — | $474.40 | — |
| TN | — | $474.40 | — |
| TX | — | $474.40 | — |
| UT | — | $474.40 | — |
| VA | — | $474.40 | — |
| VI | — | $632.54 | — |
| VT | — | $577.81 | — |
| WA | — | $571.58 | — |
| WI | — | $505.37 | — |
| WV | — | $474.40 | — |
| WY | — | $474.40 | — |
How the L4050 fee compares
| Measure | Value |
|---|---|
| Rank among 12 L40 codes (lowest = 1) | 8 |
| Family fee range (average of state fees) | $117.32–$1,638.51 |
| Rural fee uplift | — |
Who bills L4050 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 13 |
| Referring clinicians | 15 |
| Medicare beneficiaries | 16 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 17 | 19 |
| 2023 | 11 | 12 |
| 2024 | 13 | 16 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L4050, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 21 | 19 | $418.13 | $320.62 |
| 2023 | 14 | 12 | $480.05 | $376.36 |
| 2024 | 19 | 16 | $504.09 | $380.85 |
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
Covered diagnoses (12 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 |
| M14.671 | Charcot's joint, right ankle and foot | 1 |
| M14.672 | Charcot's joint, left ankle and foot | 1 |
| M24.571 | Contracture, right ankle | 1 |
| M24.572 | Contracture, left ankle | 1 |
| M24.574 | Contracture, right foot | 1 |
Showing 10 of 12. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L4050
- 2026-01-01: Average state fee rose 2.0%: $540.93 to $551.75
- 1985-01-01: L4050 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 L4050?
L4050 is the HCPCS Level II code for replace molded calf lacer, for custom fabricated orthosis only. Short descriptor: "Replace molded calf lacer".
How much does Medicare pay for L4050?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $474.40–$1,142.13. Rural fees can be higher.
Does Medicare cover L4050?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L4050?
Medicare policy articles that cite L4050 list 12 covered ICD-10-CM diagnosis codes across 1 article. 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 L4050 change in 2026?
The average non-rural state fee moved from $540.93 in 2025 to $551.75 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L4050 can be billed per day?
2 on DME suppliers; 2 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)
- L4002 — Replacement strap, any orthosis, includes all components, any length, any type
- 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)
- 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 L4050
- Watch L4050 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L4050
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.