L4100 HCPCS code: Replace leather cuff kafo, proximal thigh
L4100 is the HCPCS Level II code for replace leather cuff kafo, proximal thigh. The 2026 Medicare DMEPOS fee schedule pays $119.86 to $171.33 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 2 of 3 L41 codes (family range $111.18–$640.48).
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 | 1986-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L4100
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $119.86 | $171.33 | $159.82 | $119.86 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $159.34 | — |
| AL | — | $122.63 | — |
| AR | — | $134.81 | — |
| AZ | — | $159.82 | — |
| CA | — | $159.82 | — |
| CO | — | $119.86 | — |
| CT | — | $135.65 | — |
| DC | — | $137.45 | — |
| DE | — | $137.45 | — |
| FL | — | $122.63 | — |
| GA | — | $122.63 | — |
| HI | — | $170.35 | — |
| IA | — | $126.41 | — |
| ID | — | $159.82 | — |
| IL | — | $124.81 | — |
| IN | — | $124.81 | — |
| KS | — | $126.41 | — |
| KY | — | $122.63 | — |
| LA | — | $134.81 | — |
| MA | — | $135.65 | — |
| MD | — | $137.45 | — |
| ME | — | $135.65 | — |
| MI | — | $124.81 | — |
| MN | — | $124.81 | — |
| MO | — | $126.41 | — |
| MS | — | $122.63 | — |
| MT | — | $119.86 | — |
| NC | — | $122.63 | — |
| ND | — | $119.86 | — |
| NE | — | $126.41 | — |
| NH | — | $135.65 | — |
| NJ | — | $148.89 | — |
| NM | — | $134.81 | — |
| NV | — | $159.82 | — |
| NY | — | $148.89 | — |
| OH | — | $124.81 | — |
| OK | — | $134.81 | — |
| OR | — | $159.82 | — |
| PA | — | $137.45 | — |
| PR | — | $171.33 | — |
| RI | — | $135.65 | — |
| SC | — | $122.63 | — |
| SD | — | $119.86 | — |
| TN | — | $122.63 | — |
| TX | — | $134.81 | — |
| UT | — | $119.86 | — |
| VA | — | $137.45 | — |
| VI | — | $148.89 | — |
| VT | — | $135.65 | — |
| WA | — | $159.82 | — |
| WI | — | $124.81 | — |
| WV | — | $137.45 | — |
| WY | — | $119.86 | — |
How the L4100 fee compares
| Measure | Value |
|---|---|
| Rank among 3 L41 codes (lowest = 1) | 2 |
| Family fee range (average of state fees) | $111.18–$640.48 |
| 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 L4100
- 2026-01-01: Average state fee rose 2.0%: $132.70 to $135.36
- 1986-01-01: L4100 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 L4100?
L4100 is the HCPCS Level II code for replace leather cuff kafo, proximal thigh. Short descriptor: "Repl leath cuff kafo prox th".
How much does Medicare pay for L4100?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $119.86–$171.33. Rural fees can be higher.
Does Medicare cover L4100?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L4100 change in 2026?
The average non-rural state fee moved from $132.70 in 2025 to $135.36 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L4100 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L41 codes
- L4110 — Replace leather cuff kafo-afo, calf or distal thigh ($97.45–$171.33)
- L4130 — Replace pretibial shell ($523.52–$815.92)
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Next steps
- Run a reimbursement report for a device billed under L4100
- Watch L4100 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L4100
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.