L4370 HCPCS code: Pneumatic full leg splint, prefabricated, off-the-shelf
L4370 is the HCPCS Level II code for pneumatic full leg splint, prefabricated, off-the-shelf. The 2026 Medicare DMEPOS fee schedule pays $203.79 to $289.25 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 64% from 2022 to 2024 (111 to 40 services). In 2024, 26 suppliers billed Medicare for L4370 (purchases), serving 40 beneficiaries. Its average fee ranks 9 of 11 L43 codes (family range $20.94–$353.29).
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 | 1989-01-01 |
| Last action effective | 2014-01-01 |
2026 Medicare DMEPOS fee schedule for L4370
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $203.79 | $289.25 | $289.25 | $216.94 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $203.79 | — |
| AL | — | $216.94 | — |
| AR | — | $216.94 | — |
| AZ | — | $216.94 | — |
| CA | — | $216.94 | — |
| CO | — | $237.95 | — |
| CT | — | $289.25 | — |
| DC | — | $233.82 | — |
| DE | — | $233.82 | — |
| FL | — | $216.94 | — |
| GA | — | $216.94 | — |
| HI | — | $217.93 | — |
| IA | — | $216.94 | — |
| ID | — | $289.25 | — |
| IL | — | $289.25 | — |
| IN | — | $289.25 | — |
| KS | — | $216.94 | — |
| KY | — | $216.94 | — |
| LA | — | $216.94 | — |
| MA | — | $289.25 | — |
| MD | — | $233.82 | — |
| ME | — | $289.25 | — |
| MI | — | $289.25 | — |
| MN | — | $289.25 | — |
| MO | — | $216.94 | — |
| MS | — | $216.94 | — |
| MT | — | $237.95 | — |
| NC | — | $216.94 | — |
| ND | — | $237.95 | — |
| NE | — | $216.94 | — |
| NH | — | $289.25 | — |
| NJ | — | $216.94 | — |
| NM | — | $216.94 | — |
| NV | — | $216.94 | — |
| NY | — | $216.94 | — |
| OH | — | $289.25 | — |
| OK | — | $216.94 | — |
| OR | — | $289.25 | — |
| PA | — | $233.82 | — |
| PR | — | $213.21 | — |
| RI | — | $289.25 | — |
| SC | — | $216.94 | — |
| SD | — | $237.95 | — |
| TN | — | $216.94 | — |
| TX | — | $216.94 | — |
| UT | — | $237.95 | — |
| VA | — | $233.82 | — |
| VI | — | $216.94 | — |
| VT | — | $289.25 | — |
| WA | — | $289.25 | — |
| WI | — | $289.25 | — |
| WV | — | $233.82 | — |
| WY | — | $237.95 | — |
How the L4370 fee compares
| Measure | Value |
|---|---|
| Rank among 11 L43 codes (lowest = 1) | 9 |
| Family fee range (average of state fees) | $20.94–$353.29 |
| Rural fee uplift | — |
Who bills L4370 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 26 |
| Referring clinicians | 30 |
| Medicare beneficiaries | 40 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 47 | 110 |
| 2023 | 37 | 84 |
| 2024 | 26 | 40 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L4370, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 111 | 110 | $199.77 | $154.42 |
| 2023 | 84 | 84 | $205.33 | $156.08 |
| 2024 | 40 | 40 | $213.80 | $161.74 |
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 L4370
- 2026-01-01: Average state fee rose 2.0%: $236.66 to $241.39
- 1989-01-01: L4370 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 L4370?
L4370 is the HCPCS Level II code for pneumatic full leg splint, prefabricated, off-the-shelf. Short descriptor: "Pneum full leg splnt pre ots".
How much does Medicare pay for L4370?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $203.79–$289.25. Rural fees can be higher.
Does Medicare cover L4370?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L4370?
Medicare policy articles that cite L4370 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 L4370 change in 2026?
The average non-rural state fee moved from $236.66 in 2025 to $241.39 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L4370 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)
- L4361 — Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf ($318.18–$424.24)
- 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 L4370
- Watch L4370 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L4370
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.