HCPCS Code L5704

Custom shaped protective cover, below knee
Code effective Jan 01, 2002

HCPCS Section
Orthotic and Prosthetic Procedures, Devices

L5704 is a valid 2026 HCPCS code meaning Custom shaped protective cover, below knee or (Custom shape cover bk) for short. HCPCS L5704 has been effective since 01/01/2002 and applies to Lump sum purchase of DME, prosthetics, orthotics.

HCPCS Code Details - L5704

HCPCS Level II Code
Section L - Orthotic and Prosthetic Procedures, Devices
HCPCS Code L5704
Description

Long description:
Custom shaped protective cover, below knee

Short description:
Custom shape cover bk

HCPCS Pricing indicator 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code D1F - Prosthetic/Orthotic devices
HCPCS Action code N - No maintenance for this code
Type of service P - Lump sum purchase of DME, prosthetics, orthotics
Effective date Effective Jan 01, 2002
Date added Added Jan 01, 1994

See also

  • HCPCS L5703 · Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only

  • HCPCS L5705 · Custom shaped protective cover, above knee

  • HCPCS L5706 · Custom shaped protective cover, knee disarticulation

  • HCPCS L5707 · Custom shaped protective cover, hip disarticulation

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”

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 6/23/2026

CPT® is a registered trademark of the American Medical Association (AMA). All rights reserved.