L5781 HCPCS code: Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system
L5781 is the HCPCS Level II code for addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system. The 2026 Medicare DMEPOS fee schedule pays $4,808.77 to $5,289.62 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 9% from 2022 to 2024 (2,055 to 1,863 services). In 2024, 655 suppliers billed Medicare for L5781 (purchases), serving 1,640 beneficiaries; Texas, New York, California accounted for 37% of services. Its average fee ranks 23 of 25 L57 codes (family range $505.38–$5,985.47).
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 | 2003-01-01 |
| Last action effective | 2003-01-01 |
2026 Medicare DMEPOS fee schedule for L5781
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $4,808.77 | $5,289.62 | $5,868.42 | $4,401.32 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $4,808.77 | — |
| AL | — | $4,953.58 | — |
| AR | — | $4,953.14 | — |
| AZ | — | $4,808.77 | — |
| CA | — | $4,808.77 | — |
| CO | — | $4,980.92 | — |
| CT | — | $4,808.77 | — |
| DC | — | $4,808.77 | — |
| DE | — | $4,808.77 | — |
| FL | — | $4,953.58 | — |
| GA | — | $4,953.58 | — |
| HI | — | $4,808.77 | — |
| IA | — | $4,902.67 | — |
| ID | — | $4,808.77 | — |
| IL | — | $4,926.90 | — |
| IN | — | $4,926.90 | — |
| KS | — | $4,902.67 | — |
| KY | — | $4,953.58 | — |
| LA | — | $4,953.14 | — |
| MA | — | $4,808.77 | — |
| MD | — | $4,808.77 | — |
| ME | — | $4,808.77 | — |
| MI | — | $4,926.90 | — |
| MN | — | $4,926.90 | — |
| MO | — | $4,902.67 | — |
| MS | — | $4,953.58 | — |
| MT | — | $4,980.92 | — |
| NC | — | $4,953.58 | — |
| ND | — | $4,980.92 | — |
| NE | — | $4,902.67 | — |
| NH | — | $4,808.77 | — |
| NJ | — | $4,808.77 | — |
| NM | — | $4,953.14 | — |
| NV | — | $4,808.77 | — |
| NY | — | $4,808.77 | — |
| OH | — | $4,926.90 | — |
| OK | — | $4,953.14 | — |
| OR | — | $4,808.77 | — |
| PA | — | $4,808.77 | — |
| PR | — | $5,289.62 | — |
| RI | — | $4,808.77 | — |
| SC | — | $4,953.58 | — |
| SD | — | $4,980.92 | — |
| TN | — | $4,953.58 | — |
| TX | — | $4,953.14 | — |
| UT | — | $4,980.92 | — |
| VA | — | $4,808.77 | — |
| VI | — | $5,289.62 | — |
| VT | — | $4,808.77 | — |
| WA | — | $4,808.77 | — |
| WI | — | $4,926.90 | — |
| WV | — | $4,808.77 | — |
| WY | — | $4,980.92 | — |
How the L5781 fee compares
| Measure | Value |
|---|---|
| Rank among 25 L57 codes (lowest = 1) | 23 |
| Family fee range (average of state fees) | $505.38–$5,985.47 |
| Rural fee uplift | — |
Who bills L5781 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 655 |
| Referring clinicians | 1,301 |
| Medicare beneficiaries | 1,640 |
| States with claims | 29 |
| Share of services in top 3 states (Texas, New York, California) | 37% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 747 | 1,819 |
| 2023 | 713 | 1,790 |
| 2024 | 655 | 1,640 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L5781, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,055 | 1,819 | $4,181.54 | $3,252.54 |
| 2023 | 2,022 | 1,790 | $4,548.84 | $3,496.54 |
| 2024 | 1,863 | 1,640 | $4,673.34 | $3,609.26 |
States with the most L5781 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 323 | $3,680.46 |
| New York | 182 | $3,575.08 |
| California | 133 | $3,597.57 |
| Illinois | 94 | $3,602.89 |
| Florida | 86 | $3,705.67 |
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
- A52496: Lower Limb Prostheses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for L5781
- 2026-01-01: Average state fee rose 2.0%: $4,806.22 to $4,902.34
- 2003-01-01: L5781 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 L5781?
L5781 is the HCPCS Level II code for addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system. Short descriptor: "Lower limb pros vacuum pump".
How much does Medicare pay for L5781?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $4,808.77–$5,289.62. Rural fees can be higher.
Does Medicare cover L5781?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L5781 change in 2026?
The average non-rural state fee moved from $4,806.22 in 2025 to $4,902.34 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L5781 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L57 codes
- L5700 — Replacement, socket, below knee, molded to patient model ($3,415.10–$4,470.21)
- L5701 — Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model ($4,212.11–$5,550.13)
- L5702 — Replacement, socket, hip disarticulation, including hip joint, molded to patient model ($5,328.96–$7,985.48)
- L5703 — Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only ($2,560.96–$3,474.01)
- L5704 — Custom shaped protective cover, below knee ($656.17–$808.71)
- L5705 — Custom shaped protective cover, above knee ($1,172.40–$1,445.02)
- L5706 — Custom shaped protective cover, knee disarticulation ($1,149.30–$1,416.51)
- L5707 — Custom shaped protective cover, hip disarticulation ($1,515.21–$1,867.45)
- L5710 — Addition, exoskeletal knee-shin system, single axis, manual lock ($440.31–$838.03)
- L5711 — Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material ($628.18–$984.73)
- L5712 — Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) ($527.52–$973.68)
- L5714 — Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control ($255.56–$626.05)
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 L5781
- Watch L5781 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L5781
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.