L5450 HCPCS code: Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee
L5450 is the HCPCS Level II code for immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee. The 2026 Medicare DMEPOS fee schedule pays $368.15 to $665.02 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 38% from 2022 to 2024 (294 to 181 services). In 2024, 122 suppliers billed Medicare for L5450 (purchases), serving 157 beneficiaries. Its average fee ranks 1 of 6 L54 codes (family range $546.23–$2,107.96).
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 L5450
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $368.15 | $665.02 | $665.02 | $498.76 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $394.92 | — |
| AL | — | $501.19 | — |
| AR | — | $665.02 | — |
| AZ | — | $498.76 | — |
| CA | — | $498.76 | — |
| CO | — | $599.83 | — |
| CT | — | $498.76 | — |
| DC | — | $525.47 | — |
| DE | — | $525.47 | — |
| FL | — | $501.19 | — |
| GA | — | $501.19 | — |
| HI | — | $422.33 | — |
| IA | — | $602.60 | — |
| ID | — | $540.15 | — |
| IL | — | $582.35 | — |
| IN | — | $582.35 | — |
| KS | — | $602.60 | — |
| KY | — | $501.19 | — |
| LA | — | $665.02 | — |
| MA | — | $498.76 | — |
| MD | — | $525.47 | — |
| ME | — | $498.76 | — |
| MI | — | $582.35 | — |
| MN | — | $582.35 | — |
| MO | — | $602.60 | — |
| MS | — | $501.19 | — |
| MT | — | $599.83 | — |
| NC | — | $501.19 | — |
| ND | — | $599.83 | — |
| NE | — | $602.60 | — |
| NH | — | $498.76 | — |
| NJ | — | $554.84 | — |
| NM | — | $665.02 | — |
| NV | — | $498.76 | — |
| NY | — | $554.84 | — |
| OH | — | $582.35 | — |
| OK | — | $665.02 | — |
| OR | — | $540.15 | — |
| PA | — | $525.47 | — |
| PR | — | $368.15 | — |
| RI | — | $498.76 | — |
| SC | — | $501.19 | — |
| SD | — | $599.83 | — |
| TN | — | $501.19 | — |
| TX | — | $665.02 | — |
| UT | — | $599.83 | — |
| VA | — | $525.47 | — |
| VI | — | $554.84 | — |
| VT | — | $498.76 | — |
| WA | — | $540.15 | — |
| WI | — | $582.35 | — |
| WV | — | $525.47 | — |
| WY | — | $599.83 | — |
How the L5450 fee compares
| Measure | Value |
|---|---|
| Rank among 6 L54 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $546.23–$2,107.96 |
| Rural fee uplift | — |
Who bills L5450 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 122 |
| Referring clinicians | 148 |
| Medicare beneficiaries | 157 |
| States with claims | 3 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 169 | 263 |
| 2023 | 142 | 197 |
| 2024 | 122 | 157 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L5450, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 294 | 263 | $472.07 | $360.98 |
| 2023 | 223 | 197 | $509.64 | $392.13 |
| 2024 | 181 | 157 | $536.50 | $407.27 |
States with the most L5450 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Minnesota | 23 | $431.86 |
| Iowa | 15 | $447.25 |
| Pennsylvania | 11 | $404.45 |
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 L5450
- 2026-01-01: Average state fee rose 2.0%: $535.52 to $546.23
- 1982-01-01: L5450 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 L5450?
L5450 is the HCPCS Level II code for immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee. Short descriptor: "Postop app non-wgt bear dsg".
How much does Medicare pay for L5450?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $368.15–$665.02. Rural fees can be higher.
Does Medicare cover L5450?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L5450?
Medicare policy articles that cite L5450 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 L5450 change in 2026?
The average non-rural state fee moved from $535.52 in 2025 to $546.23 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L5450 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L54 codes
- L5400 — Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee ($869.13–$2,148.18)
- L5410 — Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment ($265.71–$682.01)
- L5420 — Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation ($1,329.43–$2,689.16)
- L5430 — Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment ($616.07–$909.91)
- L5460 — Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee ($452.25–$890.08)
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 L5450
- Watch L5450 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L5450
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.