Braces; trusses; and artifical legs, arms, and eyes are covered when furnished incident to a physician’s services or on a physician’s order. A brace includes rigid and semirigid devices used for the purpose of supporting a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body. Back braces include, but are not limited to, sacroiliac, sacrolumbar, dorsolumbar corsets, and belts. Stump stockings and harnesses (including replacements) are also covered when these appliances are essential to the effective use of an artificial limb. Adjustments to an artificial limb or other appliance required by wear or by a change in the patient’s condition are covered when ordered by a physician. Adjustments, repairs, and replacements are covered so long as the device continues to be medically required.

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• L2550

  Addition to lower extremity, thigh/weight bearing, high roll cuff

• L2570

  Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each

• L2580

  Addition to lower extremity, pelvic control, pelvic sling

• L2600

  Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each

• L2610

  Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each

• L2620

  Addition to lower extremity, pelvic control, hip joint, heavy duty, each

• L2622

  Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each

• L2624

  Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each

• L2627

  Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables

• L2628

  Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

• L2630

  Addition to lower extremity, pelvic control, band and belt, unilateral

• L2640

  Addition to lower extremity, pelvic control, band and belt, bilateral

• L2650

  Addition to lower extremity, pelvic and thoracic control, gluteal pad, each

• L2660

  Addition to lower extremity, thoracic control, thoracic band

• L2670

  Addition to lower extremity, thoracic control, paraspinal uprights

• L2680

  Addition to lower extremity, thoracic control, lateral support uprights

• L2750

  Addition to lower extremity orthosis, plating chrome or nickel, per bar

• L2755

  Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only

• L2760

  Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)

• L2768

  Orthotic side bar disconnect device, per bar

• L2780

  Addition to lower extremity orthosis, non-corrosive finish, per bar

• L2785

  Addition to lower extremity orthosis, drop lock retainer, each

• L2795

  Addition to lower extremity orthosis, knee control, full kneecap

• L2800

  Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only

• L2810

  Addition to lower extremity orthosis, knee control, condylar pad

• L2820

  Addition to lower extremity orthosis, soft interface for molded plastic, below knee section

• L2830

  Addition to lower extremity orthosis, soft interface for molded plastic, above knee section

• L2840

  Addition to lower extremity orthosis, tibial length sock, fracture or equal, each

• L2850

  Addition to lower extremity orthosis, femoral length sock, fracture or equal, each

• L2861

  Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each

• L2999

  Lower extremity orthoses, not otherwise specified

• L3000

  Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each

• L3001

  Foot, insert, removable, molded to patient model, spenco, each

• L3002

  Foot, insert, removable, molded to patient model, plastazote or equal, each

• L3003

  Foot, insert, removable, molded to patient model, silicone gel, each

• L3010

  Foot, insert, removable, molded to patient model, longitudinal arch support, each

• L3020

  Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each

• L3030

  Foot, insert, removable, formed to patient foot, each

• L3031

  Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each

• L3040

  Foot, arch support, removable, premolded, longitudinal, each

• L3050

  Foot, arch support, removable, premolded, metatarsal, each

• L3060

  Foot, arch support, removable, premolded, longitudinal/ metatarsal, each

• L3070

  Foot, arch support, non-removable attached to shoe, longitudinal, each

• L3080

  Foot, arch support, non-removable attached to shoe, metatarsal, each

• L3090

  Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each

• L3100

  Hallus-valgus night dynamic splint, prefabricated, off-the-shelf

• L3140

  Foot, abduction rotation bar, including shoes

• L3150

  Foot, abduction rotation bar, without shoes

• L3160

  Foot, adjustable shoe-styled positioning device

• L3161

  Foot, adductus positioning device, adjustable

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HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 6/3/2026

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