A52.16: Charcot's arthropathy (tabetic)
A52.16, Charcot's arthropathy (tabetic), is listed as a covered diagnosis in 11 Medicare billing and coding articles that apply to 111 HCPCS Level II codes, including L2006 (Knee ankle foot device, any material, single or double…), L2005 (Knee ankle foot orthosis, any material, single or double…), L2036 (Knee ankle foot orthosis, full plastic, double upright…). 93 of these codes have a 2026 DMEPOS fee schedule amount; L2006 pays $38,584.76 to $44,514.91 depending on the state. The articles come from 7 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with A52.16 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| L2006 | Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated | Carrier judgment | $38,584.76–$44,514.91 | 1 |
| L2005 | Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated | Carrier judgment | $4,915.21–$5,406.75 | 1 |
| L2036 | Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated | Carrier judgment | $2,131.99–$4,092.63 | 1 |
| L2020 | Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated | Carrier judgment | $1,341.77–$3,211.79 | 1 |
| L4631 | Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated | Carrier judgment | $1,710.05–$3,027.97 | 1 |
| L2037 | Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated | Carrier judgment | $1,913.97–$2,959.04 | 1 |
| L2136 | Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment | Carrier judgment | $1,358.95–$2,855.32 | 1 |
| L2034 | Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated | Carrier judgment | $2,400.14–$2,850.68 | 1 |
| L2128 | Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated | Carrier judgment | $1,808.36–$2,786.22 | 1 |
| L2000 | Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated | Carrier judgment | $1,165.54–$2,572.50 | 1 |
| L2010 | Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated | Carrier judgment | $1,062.50–$2,247.91 | 1 |
| L2038 | Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated | Carrier judgment | $1,642.94–$2,190.58 | 1 |
| L2030 | Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated | Carrier judgment | $1,164.11–$1,944.13 | 1 |
| L2126 | Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated | Carrier judgment | $1,376.03–$1,834.71 | 1 |
| L2134 | Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment | Carrier judgment | $1,111.41–$1,713.20 | 1 |
| L2108 | Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated | Carrier judgment | $999.36–$1,659.98 | 1 |
| L1945 | Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated | Carrier judgment | $780.45–$1,589.54 | 1 |
| L1940 | Ankle foot orthosis, plastic or other material, custom fabricated | Carrier judgment | $568.30–$1,522.87 | 1 |
| L1960 | Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated | Carrier judgment | $636.95–$1,522.87 | 1 |
| L2106 | Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated | Carrier judgment | $781.31–$1,468.06 | 1 |
| L4020 | Replace quadrilateral socket brim, molded to patient model | Carrier judgment | $989.77–$1,433.34 | 1 |
| L2132 | Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment | Carrier judgment | $926.98–$1,427.66 | 1 |
| L2116 | Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment | Carrier judgment | $818.05–$1,402.58 | 1 |
| L4040 | Replace molded thigh lacer, for custom fabricated orthosis only | Carrier judgment | $469.07–$1,370.51 | 1 |
| L1950 | Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated | Carrier judgment | $855.92–$1,328.25 | 1 |
86 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing A52.16
- A52457: Ankle-Foot/Knee-Ankle-Foot Orthoses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 101 Level II codes)
- A57759: Billing and Coding: Routine Foot Care and Debridement of Nails (Wellpoint Federal (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A57954: Billing and Coding: Routine Foot Care (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A57193: Billing and Coding: Routine Foot Care and Debridement of Nails (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33636, L34246
- A52996: Billing and Coding: Routine Foot Care (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56232: Billing and Coding: Foot Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes)
- A57188: Billing and Coding: Routine Foot Care (First Coast Service Options, Inc. (MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A56680: Billing and Coding: Routine Foot Care (Palmetto GBA (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33941, L35138, L37643
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
- A53064: Billing and Coding: Outpatient Occupational Therapy (Palmetto GBA (MAC - Part A); 3 Level II codes). LCD with the same title: L34427
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other A52 diagnoses (Late syphilis)
- A52.10 — Symptomatic neurosyphilis, unspecified
- A52.11 — Tabes dorsalis
- A52.13 — Late syphilitic meningitis
- A52.14 — Late syphilitic encephalitis
- A52.15 — Late syphilitic neuropathy
- A52.17 — General paresis
- A52.19 — Other symptomatic neurosyphilis
- A52.01 — Syphilitic aneurysm of aorta
- A52.02 — Syphilitic aortitis
- A52.03 — Syphilitic endocarditis
- A52.06 — Other syphilitic heart involvement
- A52.2 — Asymptomatic neurosyphilis
- A52.3 — Neurosyphilis, unspecified
- A52.76 — Other genitourinary symptomatic late syphilis
Frequently asked questions
Does Medicare cover A52.16 (Charcot's arthropathy (tabetic))?
Medicare covers items and services, not diagnoses. 11 Medicare billing and coding articles list A52.16 as a covered diagnosis for 111 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 A52.16?
The Level II codes from the policies most specific to this diagnosis are L2006 (Knee ankle foot device, any material, single or double…, 1 article); L2005 (Knee ankle foot orthosis, any material, single or double…, 1 article); L2036 (Knee ankle foot orthosis, full plastic, double upright…, 1 article); L2020 (Knee ankle foot orthosis, double upright, free ankle…, 1 article); L4631 (Ankle foot orthosis, walking boot type, varus/valgus…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with A52.16?
Under the 2026 DMEPOS fee schedule (non-rural state fees): L2006 $38,584.76 to $44,514.91; L2005 $4,915.21 to $5,406.75; L2036 $2,131.99 to $4,092.63; L2020 $1,341.77 to $3,211.79. Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list A52.16?
A52457 (Ankle-Foot/Knee-Ankle-Foot Orthoses - Policy Article); A57759 (Billing and Coding: Routine Foot Care and Debridement of Nails); A57954 (Billing and Coding: Routine Foot Care), and 8 more articles.
What is ICD-10-CM code A52.16?
A52.16 is the ICD-10-CM code for Charcot's arthropathy (tabetic), in category A52 (Late syphilis), chapter 1: Certain infectious and parasitic diseases.
Next steps
- Run a reimbursement report for a device billed under L2006
- Watch L2006 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L2006
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 1: Certain infectious and parasitic diseases · All diagnoses · HCPCS lookup