L5270 HCPCS code: Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot
L5270 is the HCPCS Level II code for hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot. The 2026 Medicare DMEPOS fee schedule pays $4,875.36 to $11,580.41 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 5 of 7 L52 codes (family range $3,385.67–$7,497.99).
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 | 1982-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L5270
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $4,875.36 | $11,580.41 | $8,395.23 | $6,296.42 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $10,829.85 | — |
| AL | — | $6,323.89 | — |
| AR | — | $6,563.13 | — |
| AZ | — | $8,395.23 | — |
| CA | — | $8,395.23 | — |
| CO | — | $7,278.21 | — |
| CT | — | $7,323.23 | — |
| DC | — | $6,296.42 | — |
| DE | — | $6,296.42 | — |
| FL | — | $6,323.89 | — |
| GA | — | $6,323.89 | — |
| HI | — | $11,580.41 | — |
| IA | — | $7,478.23 | — |
| ID | — | $8,395.23 | — |
| IL | — | $7,671.01 | — |
| IN | — | $7,671.01 | — |
| KS | — | $7,478.23 | — |
| KY | — | $6,323.89 | — |
| LA | — | $6,563.13 | — |
| MA | — | $7,323.23 | — |
| MD | — | $6,296.42 | — |
| ME | — | $7,323.23 | — |
| MI | — | $7,671.01 | — |
| MN | — | $7,671.01 | — |
| MO | — | $7,478.23 | — |
| MS | — | $6,323.89 | — |
| MT | — | $7,278.21 | — |
| NC | — | $6,323.89 | — |
| ND | — | $7,278.21 | — |
| NE | — | $7,478.23 | — |
| NH | — | $7,323.23 | — |
| NJ | — | $6,296.42 | — |
| NM | — | $6,563.13 | — |
| NV | — | $8,395.23 | — |
| NY | — | $6,296.42 | — |
| OH | — | $7,671.01 | — |
| OK | — | $6,563.13 | — |
| OR | — | $8,395.23 | — |
| PA | — | $6,296.42 | — |
| PR | — | $4,875.36 | — |
| RI | — | $7,323.23 | — |
| SC | — | $6,323.89 | — |
| SD | — | $7,278.21 | — |
| TN | — | $6,323.89 | — |
| TX | — | $6,563.13 | — |
| UT | — | $7,278.21 | — |
| VA | — | $6,296.42 | — |
| VI | — | $6,296.42 | — |
| VT | — | $7,323.23 | — |
| WA | — | $8,395.23 | — |
| WI | — | $7,671.01 | — |
| WV | — | $6,296.42 | — |
| WY | — | $7,278.21 | — |
How the L5270 fee compares
| Measure | Value |
|---|---|
| Rank among 7 L52 codes (lowest = 1) | 5 |
| Family fee range (average of state fees) | $3,385.67–$7,497.99 |
| 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 |
Medicare policy articles for this code
- A52481: Orthopedic Footwear - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A52496: Lower Limb Prostheses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (84 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| Q72.00 | Congenital complete absence of unspecified lower limb | 1 |
| Q72.01 | Congenital complete absence of right lower limb | 1 |
| Q72.02 | Congenital complete absence of left lower limb | 1 |
| Q72.03 | Congenital complete absence of lower limb, bilateral | 1 |
| Q72.30 | Congenital absence of unspecified foot and toe(s) | 1 |
| Q72.31 | Congenital absence of right foot and toe(s) | 1 |
| Q72.32 | Congenital absence of left foot and toe(s) | 1 |
| Q72.33 | Congenital absence of foot and toe(s), bilateral | 1 |
| Q72.70 | Split foot, unspecified lower limb | 1 |
| Q72.71 | Split foot, right lower limb | 1 |
Showing 10 of 84. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L5270
- 2026-01-01: Average state fee rose 2.0%: $7,052.89 to $7,193.95
- 1982-01-01: L5270 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 L5270?
L5270 is the HCPCS Level II code for hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot. Short descriptor: "Tilt table locking hip sing".
How much does Medicare pay for L5270?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $4,875.36–$11,580.41. Rural fees can be higher.
Does Medicare cover L5270?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L5270?
Medicare policy articles that cite L5270 list 84 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include Q72.00 (Congenital complete absence of unspecified lower limb), Q72.01 (Congenital complete absence of right lower limb), Q72.02 (Congenital complete absence of left lower limb). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for L5270 change in 2026?
The average non-rural state fee moved from $7,052.89 in 2025 to $7,193.95 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L5270 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L52 codes
- L5200 — Above knee, molded socket, single axis constant friction knee, shin, sach foot ($4,044.27–$5,901.01)
- L5210 — Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each ($2,970.73–$5,520.31)
- L5220 — Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each ($3,376.78–$5,593.50)
- L5230 — Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot ($4,657.24–$7,081.06)
- L5250 — Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot ($6,352.07–$12,373.02)
- L5280 — Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot ($6,233.46–$12,932.84)
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Next steps
- Run a reimbursement report for a device billed under L5270
- Watch L5270 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L5270
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.