S98.311A: Complete traumatic amputation of right midfoot, initial encounter
S98.311A, complete traumatic amputation of right midfoot, initial encounter, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 171 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 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 S98.311A 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 |
146 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing S98.311A
- 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)
- 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)
- S98.312A — 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
- S98.011A — 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
- S98.211A — Complete traumatic amputation of two or more right lesser toes…
- S98.212A — Complete traumatic amputation of two or more left lesser toes…
- S98.221A — Partial traumatic amputation of two or more right lesser toes…
- S98.222A — Partial traumatic amputation of two or more left lesser toes…
- 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 S98.311A (Complete traumatic amputation of right midfoot, initial…)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list S98.311A as a covered diagnosis for 171 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 S98.311A?
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 S98.311A?
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 S98.311A?
A52481 (Orthopedic Footwear - Policy Article); A57554 (Billing and Coding: Immune Globulins); A52438 (Billing and Coding: Tetanus Immunization), and 1 more article.
What is ICD-10-CM code S98.311A?
S98.311A is the ICD-10-CM code for complete traumatic amputation of right midfoot, 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