S98.222A: Partial traumatic amputation of two or more left lesser toes, initial encounter
S98.222A, partial traumatic amputation of two or more left lesser toes, initial encounter, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 180 HCPCS Level II codes, including L5280 (Hemipelvectomy, canadian type; molded socket, hip joint…), L5341 (Hemipelvectomy, canadian type, molded socket, endoskeletal…), L5250 (Hip disarticulation, canadian type; molded socket, hip…). 111 of these codes have a 2026 DMEPOS fee schedule amount; L5280 pays $6,233.46 to $12,932.84 depending on the state. The articles come from 3 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 S98.222A as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| L5280 | Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot | Carrier judgment | $6,233.46–$12,932.84 | 1 |
| L5341 | Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot | Carrier judgment | $6,039.09–$12,930.77 | 1 |
| L5250 | Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot | Carrier judgment | $6,352.07–$12,373.02 | 1 |
| L5270 | Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot | Carrier judgment | $4,875.36–$11,580.41 | 1 |
| L5595 | Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model | Carrier judgment | $4,929.43–$11,195.96 | 1 |
| L5600 | Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model | Carrier judgment | $5,443.57–$10,073.55 | 1 |
| L5331 | Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot | Carrier judgment | $4,859.45–$7,517.95 | 1 |
| L5160 | Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot | Carrier judgment | $4,676.12–$7,476.32 | 1 |
| L5230 | Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot | Carrier judgment | $4,657.24–$7,081.06 | 1 |
| L5105 | Below knee, plastic socket, joints and thigh lacer, sach foot | Carrier judgment | $4,252.97–$6,738.28 | 1 |
| L5321 | Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee | Carrier judgment | $4,023.73–$6,709.86 | 1 |
| L5150 | Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot | Carrier judgment | $4,299.18–$6,662.40 | 1 |
| L5200 | Above knee, molded socket, single axis constant friction knee, shin, sach foot | Carrier judgment | $4,044.27–$5,901.01 | 1 |
| L5220 | Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each | Carrier judgment | $3,376.78–$5,593.50 | 1 |
| L5210 | Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each | Carrier judgment | $2,970.73–$5,520.31 | 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 |
| L5312 | Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system | Carrier judgment | $3,936.65–$5,384.23 | 1 |
| L5060 | Ankle, symes, metal frame, molded leather socket, articulated ankle/foot | Carrier judgment | $1,022.60–$4,748.30 | 1 |
| L5590 | Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model | Carrier judgment | $2,943.01–$4,568.53 | 1 |
| L5585 | Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket | Carrier judgment | $3,132.31–$4,568.53 | 1 |
| L5560 | Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model | Carrier judgment | $2,379.43–$4,568.53 | 1 |
| L5301 | Below knee, molded socket, shin, sach foot, endoskeletal system | Carrier judgment | $2,810.90–$4,330.82 | 1 |
| L5580 | Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model | Carrier judgment | $1,738.32–$4,142.56 | 1 |
| L5505 | Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed | Carrier judgment | $2,129.35–$3,997.43 | 1 |
| L5050 | Ankle, symes, molded socket, sach foot | Carrier judgment | $2,809.59–$3,807.08 | 1 |
155 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing S98.222A
- A52481: Orthopedic Footwear - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 144 Level II codes). LCD with the same title: L33641
- A57554: Billing and Coding: Immune Globulins (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 20 Level II codes). LCD with the same title: L34771
- A52438: Billing and Coding: Tetanus Immunization (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes)
- A54767: Billing and Coding: Medicare Preventive Coverage for Certain Vaccines (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes)
- 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 S98 diagnoses (Traumatic amputation of ankle and foot)
- S98.221A — Partial traumatic amputation of two or more right lesser toes…
- S98.211A — Complete traumatic amputation of two or more right lesser toes…
- S98.212A — Complete traumatic amputation of two or more left lesser toes…
- S98.011A — Complete traumatic amputation of right foot at ankle level, initial…
- S98.012A — Complete traumatic amputation of left foot at ankle level, initial…
- S98.021A — Partial traumatic amputation of right foot at ankle level, initial…
- S98.022A — Partial traumatic amputation of left foot at ankle level, initial…
- S98.111A — Complete traumatic amputation of right great toe, initial encounter
- S98.112A — Complete traumatic amputation of left great toe, initial encounter
- S98.121A — Partial traumatic amputation of right great toe, initial encounter
- S98.122A — Partial traumatic amputation of left great toe, initial encounter
- S98.131A — Complete traumatic amputation of one right lesser toe, initial…
- S98.132A — Complete traumatic amputation of one left lesser toe, initial…
- S98.141A — Partial traumatic amputation of one right lesser toe, initial…
- S98.142A — Partial traumatic amputation of one left lesser toe, initial encounter
- S98.311A — Complete traumatic amputation of right midfoot, initial encounter
- S98.312A — Complete traumatic amputation of left midfoot, initial encounter
- S98.321A — Partial traumatic amputation of right midfoot, initial encounter
- S98.322A — Partial traumatic amputation of left midfoot, initial encounter
- S98.911A — Complete traumatic amputation of right foot, level unspecified…
- S98.912A — Complete traumatic amputation of left foot, level unspecified…
Frequently asked questions
Does Medicare cover S98.222A (Partial traumatic amputation of two or more left lesser…)?
Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list S98.222A as a covered diagnosis for 180 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 S98.222A?
The Level II codes from the policies most specific to this diagnosis are L5280 (Hemipelvectomy, canadian type; molded socket, hip joint…, 1 article); L5341 (Hemipelvectomy, canadian type, molded socket, endoskeletal…, 1 article); L5250 (Hip disarticulation, canadian type; molded socket, hip…, 1 article); L5270 (Hip disarticulation, tilt table type; molded socket…, 1 article); L5595 (Preparatory, hip disarticulation-hemipelvectomy, pylon, no…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with S98.222A?
Under the 2026 DMEPOS fee schedule (non-rural state fees): L5280 $6,233.46 to $12,932.84; L5341 $6,039.09 to $12,930.77; L5250 $6,352.07 to $12,373.02; L5270 $4,875.36 to $11,580.41. Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list S98.222A?
A52481 (Orthopedic Footwear - Policy Article); A57554 (Billing and Coding: Immune Globulins); A52438 (Billing and Coding: Tetanus Immunization), and 2 more articles.
What is ICD-10-CM code S98.222A?
S98.222A is the ICD-10-CM code for partial traumatic amputation of two or more left lesser toes, initial encounter, in category S98 (Traumatic amputation of ankle and foot), chapter 19: Injury, poisoning and other consequences of external causes.
Next steps
- Run a reimbursement report for a device billed under L5280
- Watch L5280 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L5280
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