L5978 HCPCS code: All lower extremity prostheses, foot, multiaxial ankle/foot
L5978 is the HCPCS Level II code for all lower extremity prostheses, foot, multiaxial ankle/foot. The 2026 Medicare DMEPOS fee schedule pays $228.16 to $652.23 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 5% from 2022 to 2024 (22 to 21 services). In 2024, 14 suppliers billed Medicare for L5978 (purchases), serving 19 beneficiaries. Its average fee ranks 5 of 32 L59 codes (family range $280.68–$21,399.63).
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 L5978
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $228.16 | $652.23 | $476.36 | $357.27 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $609.95 | — |
| AL | — | $357.27 | — |
| AR | — | $416.66 | — |
| AZ | — | $476.36 | — |
| CA | — | $476.36 | — |
| CO | — | $357.27 | — |
| CT | — | $454.71 | — |
| DC | — | $357.27 | — |
| DE | — | $357.27 | — |
| FL | — | $357.27 | — |
| GA | — | $357.27 | — |
| HI | — | $652.23 | — |
| IA | — | $476.36 | — |
| ID | — | $433.15 | — |
| IL | — | $383.44 | — |
| IN | — | $383.44 | — |
| KS | — | $476.36 | — |
| KY | — | $357.27 | — |
| LA | — | $416.66 | — |
| MA | — | $454.71 | — |
| MD | — | $357.27 | — |
| ME | — | $454.71 | — |
| MI | — | $383.44 | — |
| MN | — | $383.44 | — |
| MO | — | $476.36 | — |
| MS | — | $357.27 | — |
| MT | — | $357.27 | — |
| NC | — | $357.27 | — |
| ND | — | $357.27 | — |
| NE | — | $476.36 | — |
| NH | — | $454.71 | — |
| NJ | — | $357.27 | — |
| NM | — | $416.66 | — |
| NV | — | $476.36 | — |
| NY | — | $357.27 | — |
| OH | — | $383.44 | — |
| OK | — | $416.66 | — |
| OR | — | $433.15 | — |
| PA | — | $357.27 | — |
| PR | — | $228.16 | — |
| RI | — | $454.71 | — |
| SC | — | $357.27 | — |
| SD | — | $357.27 | — |
| TN | — | $357.27 | — |
| TX | — | $416.66 | — |
| UT | — | $357.27 | — |
| VA | — | $357.27 | — |
| VI | — | $357.27 | — |
| VT | — | $454.71 | — |
| WA | — | $433.15 | — |
| WI | — | $383.44 | — |
| WV | — | $357.27 | — |
| WY | — | $357.27 | — |
How the L5978 fee compares
| Measure | Value |
|---|---|
| Rank among 32 L59 codes (lowest = 1) | 5 |
| Family fee range (average of state fees) | $280.68–$21,399.63 |
| Rural fee uplift | — |
Who bills L5978 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 14 |
| Referring clinicians | 19 |
| Medicare beneficiaries | 19 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 14 | 20 |
| 2023 | 16 | 20 |
| 2024 | 14 | 19 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L5978, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 22 | 20 | $354.18 | $279.17 |
| 2023 | 24 | 20 | $375.96 | $294.76 |
| 2024 | 21 | 19 | $407.44 | $319.44 |
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 L5978
- 2026-01-01: Average state fee rose 2.0%: $396.85 to $404.79
- 1989-01-01: L5978 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 L5978?
L5978 is the HCPCS Level II code for all lower extremity prostheses, foot, multiaxial ankle/foot. Short descriptor: "Ft prosth multiaxial ankl/ft".
How much does Medicare pay for L5978?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $228.16–$652.23. Rural fees can be higher.
Does Medicare cover L5978?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L5978 change in 2026?
The average non-rural state fee moved from $396.85 in 2025 to $404.79 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L5978 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L59 codes
- L5910 — Addition, endoskeletal system, below knee, alignable system ($379.75–$856.60)
- L5920 — Addition, endoskeletal system, above knee or hip disarticulation, alignable system ($612.00–$1,713.20)
- L5925 — Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock ($411.36–$742.65)
- L5926 — Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type ($494.92–$1,173.77)
- L5930 — Addition, endoskeletal system, high activity knee control frame ($4,045.31–$4,449.83)
- L5940 — Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) ($614.10–$1,142.13)
- L5950 — Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) ($939.43–$1,269.97)
- L5960 — Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) ($1,134.89–$2,331.87)
- L5961 — Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control ($5,299.60–$6,659.78)
- L5962 — Addition, endoskeletal system, below knee, flexible protective outer surface covering system ($719.60–$959.46)
- L5964 — Addition, endoskeletal system, above knee, flexible protective outer surface covering system ($1,146.54–$1,408.24)
- L5966 — Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system ($1,460.97–$1,825.66)
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Next steps
- Run a reimbursement report for a device billed under L5978
- Watch L5978 for fee, coverage and descriptor changes
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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.