S82.012C: Displaced osteochondral fracture of left patella, initial encounter for open fracture type IIIA, IIIB, or IIIC
S82.012C, displaced osteochondral fracture of left patella, initial encounter for open fracture type IIIA, IIIB, or IIIC, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 69 HCPCS Level II codes, including G0008 (Administration of influenza virus vaccine), G0009 (Administration of pneumococcal vaccine), G0010 (Administration of hepatitis b vaccine). 47 of these codes have a 2026 DMEPOS fee schedule amount; L1844 pays $1,865.51 to $2,436.24 depending on the state. The articles come from 2 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 S82.012C as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0008 | Administration of influenza virus vaccine | Carrier judgment | — | 1 |
| G0009 | Administration of pneumococcal vaccine | Carrier judgment | — | 1 |
| G0010 | Administration of hepatitis b vaccine | Carrier judgment | — | 1 |
| Q2038 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) | Special coverage instructions apply | — | 1 |
| Q2035 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) | Special coverage instructions apply | — | 1 |
| Q2037 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) | Special coverage instructions apply | — | 1 |
| Q2034 | Influenza virus vaccine, split virus, for intramuscular use (agriflu) | Special coverage instructions apply | — | 1 |
| Q2036 | Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) | Special coverage instructions apply | — | 1 |
| Q2039 | Influenza virus vaccine, not otherwise specified | Special coverage instructions apply | — | 1 |
| L1844 | Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated | Carrier judgment | $1,865.51–$2,436.24 | 1 |
| L1860 | Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk) | Carrier judgment | $1,233.07–$1,985.94 | 1 |
| L1846 | Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated | Carrier judgment | $1,283.72–$1,960.17 | 1 |
| L1834 | Knee orthosis, without knee joint, rigid, custom fabricated | Carrier judgment | $892.02–$1,808.36 | 1 |
| L1832 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Carrier judgment | $698.63–$1,618.03 | 1 |
| L1840 | Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated | Carrier judgment | $1,056.60–$1,606.15 | 1 |
| L1843 | Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Carrier judgment | $1,076.26–$1,183.90 | 1 |
| L1845 | Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Carrier judgment | $939.24–$1,180.51 | 1 |
| L1833 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | Carrier judgment | $455.16–$1,087.16 | 1 |
| L1851 | Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf | Carrier judgment | $600.78–$959.09 | 1 |
| L1852 | Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf | Carrier judgment | $573.13–$940.49 | 1 |
| L2330 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only | Carrier judgment | $429.42–$904.14 | 1 |
| L1847 | Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Carrier judgment | $689.92–$827.89 | 1 |
| L1848 | Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf | Carrier judgment | $689.92–$827.89 | 1 |
| L1850 | Knee orthosis, swedish type, prefabricated, off-the-shelf | Carrier judgment | $205.78–$408.53 | 1 |
| L2820 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | Carrier judgment | $99.79–$399.72 | 1 |
44 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing S82.012C
- A54767: Billing and Coding: Medicare Preventive Coverage for Certain Vaccines (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes)
- A52465: Knee Orthoses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 53 Level II codes). LCD with the same title: L33318
- A57311: Billing and Coding: Physical Therapy - Home Health (CGS Administrators, LLC (HHH MAC); 7 Level II codes). LCD with the same title: L33942
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 S82 diagnoses (Fracture of lower leg, including ankle)
- S82.012B — Displaced osteochondral fracture of left patella, initial encounter…
- S82.011B — Displaced osteochondral fracture of right patella, initial encounter…
- S82.011C — Displaced osteochondral fracture of right patella, initial encounter…
- S82.014B — Nondisplaced osteochondral fracture of right patella, initial…
- S82.014C — Nondisplaced osteochondral fracture of right patella, initial…
- S82.015B — Nondisplaced osteochondral fracture of left patella, initial…
- S82.015C — Nondisplaced osteochondral fracture of left patella, initial…
- S82.021B — Displaced longitudinal fracture of right patella, initial encounter…
- S82.021C — Displaced longitudinal fracture of right patella, initial encounter…
- S82.022B — Displaced longitudinal fracture of left patella, initial encounter…
- S82.022C — Displaced longitudinal fracture of left patella, initial encounter…
- S82.024B — Nondisplaced longitudinal fracture of right patella, initial…
- S82.024C — Nondisplaced longitudinal fracture of right patella, initial…
- S82.025B — Nondisplaced longitudinal fracture of left patella, initial…
- S82.025C — Nondisplaced longitudinal fracture of left patella, initial…
- S82.031B — Displaced transverse fracture of right patella, initial encounter…
- S82.031C — Displaced transverse fracture of right patella, initial encounter…
- S82.032B — Displaced transverse fracture of left patella, initial encounter for…
- S82.032C — Displaced transverse fracture of left patella, initial encounter for…
- S82.034B — Nondisplaced transverse fracture of right patella, initial encounter…
- S82.034C — Nondisplaced transverse fracture of right patella, initial encounter…
- S82.035B — Nondisplaced transverse fracture of left patella, initial encounter…
- S82.035C — Nondisplaced transverse fracture of left patella, initial encounter…
- S82.041B — Displaced comminuted fracture of right patella, initial encounter…
- S82.041C — Displaced comminuted fracture of right patella, initial encounter…
- S82.042B — Displaced comminuted fracture of left patella, initial encounter for…
- S82.042C — Displaced comminuted fracture of left patella, initial encounter for…
- S82.044B — Nondisplaced comminuted fracture of right patella, initial encounter…
- S82.044C — Nondisplaced comminuted fracture of right patella, initial encounter…
- S82.045B — Nondisplaced comminuted fracture of left patella, initial encounter…
Frequently asked questions
Does Medicare cover S82.012C (Displaced osteochondral fracture of left patella, initial…)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list S82.012C as a covered diagnosis for 69 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 S82.012C?
The Level II codes from the policies most specific to this diagnosis are G0008 (Administration of influenza virus vaccine, 1 article); G0009 (Administration of pneumococcal vaccine, 1 article); G0010 (Administration of hepatitis b vaccine, 1 article); Q2038 (Influenza virus vaccine, split virus, when administered to…, 1 article); Q2035 (Influenza virus vaccine, split virus, when administered to…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with S82.012C?
Under the 2026 DMEPOS fee schedule (non-rural state fees): L1844 $1,865.51 to $2,436.24; L1860 $1,233.07 to $1,985.94; L1846 $1,283.72 to $1,960.17; L1834 $892.02 to $1,808.36. Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list S82.012C?
A54767 (Billing and Coding: Medicare Preventive Coverage for Certain Vaccines); A52465 (Knee Orthoses - Policy Article); A57311 (Billing and Coding: Physical Therapy - Home Health).
What is ICD-10-CM code S82.012C?
S82.012C is the ICD-10-CM code for displaced osteochondral fracture of left patella, initial encounter for open fracture type IIIA, IIIB, or IIIC, in category S82 (Fracture of lower leg, including ankle), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under G0008
- Watch G0008 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0008
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 19: Injury, poisoning and other consequences of external causes · All diagnoses · HCPCS lookup