L4361 HCPCS code: Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf

L4361 is the HCPCS Level II code for walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf. The 2026 Medicare DMEPOS fee schedule pays $318.18 to $424.24 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 rose 4% from 2022 to 2024 (151,214 to 157,737 services). In 2024, 6,225 suppliers billed Medicare for L4361 (purchases), serving 156,477 beneficiaries; California, Florida, Texas accounted for 21% of services. Its average fee ranks 10 of 11 L43 codes (family range $20.94–$353.29).

Code details

2026 Medicare DMEPOS fee schedule for L4361

How the L4361 fee compares

Who bills L4361 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for L4361, 2022–2024

States with the most L4361 services (2024)

NCCI unit limits (MUE)

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:

Showing 10 of 12. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for L4361

• 2026-01-01: Average state fee rose 2.0%: $346.36 to $353.29
• 2014-01-01: L4361 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 L4361?

L4361 is the HCPCS Level II code for walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf. Short descriptor: "Pneuma/vac walk boot pre ots".

How much does Medicare pay for L4361?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $318.18–$424.24. Rural fees can be higher.

Does Medicare cover L4361?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for L4361?

Medicare policy articles that cite L4361 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 L4361 change in 2026?

The average non-rural state fee moved from $346.36 in 2025 to $353.29 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of L4361 can be billed per day?

2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).

Related L43 codes

• L4350 — Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf ($79.39–$207.41)
• L4360 — Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($318.18–$424.24)
• L4370 — Pneumatic full leg splint, prefabricated, off-the-shelf ($203.79–$289.25)
• L4386 — Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($190.16–$209.24)
• L4387 — Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf ($190.16–$209.24)
• L4392 — Replacement, soft interface material, static afo ($27.75–$33.87)
• L4394 — Replace soft interface material, foot drop splint ($20.22–$24.74)
• L4396 — Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($197.90–$241.56)
• L4397 — Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf ($197.90–$241.56)
• L4398 — Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf ($91.13–$111.17)

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 L4361
• Watch L4361 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for L4361

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.

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