Z96.653: Presence of artificial knee joint, bilateral
Z96.653, presence of artificial knee joint, bilateral, is listed as a covered diagnosis in 5 Medicare billing and coding articles that apply to 65 HCPCS Level II codes, including G0283 (Electrical stimulation (unattended), to one or more areas…), G0281 (Electrical stimulation, (unattended), to one or more…), G0329 (Electromagnetic therapy, to one or more areas for chronic…). 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 Z96.653 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 3 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 2 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 2 |
| 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 |
| L2830 | Addition to lower extremity orthosis, soft interface for molded plastic, above knee section | Carrier judgment | $107.96–$399.72 | 1 |
| L1831 | Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment | Carrier judgment | $353.04–$388.33 | 1 |
| L2320 | Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only | Carrier judgment | $236.44–$325.94 | 1 |
| L2395 | Addition to lower extremity, offset knee joint, heavy duty, each joint | Carrier judgment | $76.15–$251.19 | 1 |
| L2390 | Addition to lower extremity, offset knee joint, each joint | Carrier judgment | $76.15–$227.94 | 1 |
| L2385 | Addition to lower extremity, straight knee joint, heavy duty, each joint | Carrier judgment | $51.03–$225.93 | 1 |
40 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing Z96.653
- A60250: Billing and Coding: Total Joint Arthroplasty (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L33456, L36039, L39911, L40232
- 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
- 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
- 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 Z96 diagnoses (Presence of other functional implants)
- Z96.651 — Presence of right artificial knee joint
- Z96.652 — Presence of left artificial knee joint
- Z96.612 — Presence of left artificial shoulder joint
- Z96.622 — Presence of left artificial elbow joint
- Z96.631 — Presence of right artificial wrist joint
- Z96.641 — Presence of right artificial hip joint
- Z96.642 — Presence of left artificial hip joint
- Z96.643 — Presence of artificial hip joint, bilateral
- Z96.661 — Presence of right artificial ankle joint
- Z96.662 — Presence of left artificial ankle joint
- Z96.692 — Finger-joint replacement of left hand
- Z96.693 — Finger-joint replacement, bilateral
- Z96.698 — Presence of other orthopedic joint implants
- Z96.3 — Presence of artificial larynx
- Z96.7 — Presence of other bone and tendon implants
Frequently asked questions
Does Medicare cover Z96.653 (Presence of artificial knee joint, bilateral)?
Medicare covers items and services, not diagnoses. 5 Medicare billing and coding articles list Z96.653 as a covered diagnosis for 65 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 Z96.653?
The Level II codes from the policies most specific to this diagnosis are G0283 (Electrical stimulation (unattended), to one or more areas…, 3 articles); G0281 (Electrical stimulation, (unattended), to one or more…, 2 articles); G0329 (Electromagnetic therapy, to one or more areas for chronic…, 2 articles); L1844 (Knee orthosis, single upright, thigh and calf, with…, 1 article); L1860 (Knee orthosis, modification of supracondylar prosthetic…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with Z96.653?
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 Z96.653?
A60250 (Billing and Coding: Total Joint Arthroplasty); A52465 (Knee Orthoses - Policy Article); A53057 (Billing and Coding: Home Health Occupational Therapy), and 2 more articles.
What is ICD-10-CM code Z96.653?
Z96.653 is the ICD-10-CM code for presence of artificial knee joint, bilateral, in category Z96 (Presence of other functional implants), chapter 22: Factors influencing health status and contact with health services.
Next steps
- Run a reimbursement report for a device billed under G0283
- Watch G0283 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0283
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 22: Factors influencing health status and contact with health services · All diagnoses · HCPCS lookup