L5600 HCPCS code: Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model
L5600 is the HCPCS Level II code for preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model. The 2026 Medicare DMEPOS fee schedule pays $5,443.57 to $10,073.55 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 67 of 68 L56 codes (family range $55.23–$7,528.87).
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 | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L5600
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $5,443.57 | $10,073.55 | $7,258.09 | $5,443.57 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $9,420.63 | — |
| AL | — | $5,588.93 | — |
| AR | — | $5,443.57 | — |
| AZ | — | $7,258.09 | — |
| CA | — | $7,258.09 | — |
| CO | — | $5,443.57 | — |
| CT | — | $7,159.07 | — |
| DC | — | $5,642.33 | — |
| DE | — | $5,642.33 | — |
| FL | — | $5,588.93 | — |
| GA | — | $5,588.93 | — |
| HI | — | $10,073.55 | — |
| IA | — | $5,493.81 | — |
| ID | — | $6,965.78 | — |
| IL | — | $6,421.23 | — |
| IN | — | $6,421.23 | — |
| KS | — | $5,493.81 | — |
| KY | — | $5,588.93 | — |
| LA | — | $5,443.57 | — |
| MA | — | $7,159.07 | — |
| MD | — | $5,642.33 | — |
| ME | — | $7,159.07 | — |
| MI | — | $6,421.23 | — |
| MN | — | $6,421.23 | — |
| MO | — | $5,493.81 | — |
| MS | — | $5,588.93 | — |
| MT | — | $5,443.57 | — |
| NC | — | $5,588.93 | — |
| ND | — | $5,443.57 | — |
| NE | — | $5,493.81 | — |
| NH | — | $7,159.07 | — |
| NJ | — | $6,020.12 | — |
| NM | — | $5,443.57 | — |
| NV | — | $7,258.09 | — |
| NY | — | $6,020.12 | — |
| OH | — | $6,421.23 | — |
| OK | — | $5,443.57 | — |
| OR | — | $6,965.78 | — |
| PA | — | $5,642.33 | — |
| PR | — | $8,565.94 | — |
| RI | — | $7,159.07 | — |
| SC | — | $5,588.93 | — |
| SD | — | $5,443.57 | — |
| TN | — | $5,588.93 | — |
| TX | — | $5,443.57 | — |
| UT | — | $5,443.57 | — |
| VA | — | $5,642.33 | — |
| VI | — | $6,020.12 | — |
| VT | — | $7,159.07 | — |
| WA | — | $6,965.78 | — |
| WI | — | $6,421.23 | — |
| WV | — | $5,642.33 | — |
| WY | — | $5,443.57 | — |
How the L5600 fee compares
| Measure | Value |
|---|---|
| Rank among 68 L56 codes (lowest = 1) | 67 |
| Family fee range (average of state fees) | $55.23–$7,528.87 |
| 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 L5600
- 2026-01-01: Average state fee rose 2.0%: $6,117.16 to $6,239.51
- 1989-01-01: L5600 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 L5600?
L5600 is the HCPCS Level II code for preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model. Short descriptor: "Hip disart sach laminat mold".
How much does Medicare pay for L5600?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $5,443.57–$10,073.55. Rural fees can be higher.
Does Medicare cover L5600?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L5600?
Medicare policy articles that cite L5600 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 L5600 change in 2026?
The average non-rural state fee moved from $6,117.16 in 2025 to $6,239.51 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L5600 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L56 codes
- L5610 — Addition to lower extremity, endoskeletal system, above knee, hydracadence system ($2,534.66–$3,807.08)
- L5611 — Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control ($1,972.47–$2,747.18)
- L5613 — Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control ($2,522.22–$4,561.30)
- L5614 — Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control ($2,028.06–$2,230.84)
- L5615 — Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control ($6,603.89–$9,833.55)
- L5616 — Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control ($1,427.66–$2,216.96)
- L5617 — Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each ($672.42–$739.74)
- L5618 — Addition to lower extremity, test socket, symes ($319.44–$459.08)
- L5620 — Addition to lower extremity, test socket, below knee ($340.36–$483.98)
- L5622 — Addition to lower extremity, test socket, knee disarticulation ($443.82–$1,237.32)
- L5624 — Addition to lower extremity, test socket, above knee ($445.08–$677.51)
- L5626 — Addition to lower extremity, test socket, hip disarticulation ($583.70–$1,522.87)
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 L5600
- Watch L5600 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L5600
Sources: CMS HCPCS Level II release October 2026; 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.