HCPCS Code Details - L4055

HCPCS Level II Code
Orthotic and Prosthetic Procedures, Devices
HCPCS Code L4055
Description

Long description:
Replace non-molded calf lacer, for custom fabricated orthosis only

Short description:
Replace non-molded calf lace

HCPCS Modifier1
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, 2005
Date added Added Jan 01, 1988
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

See also

  • HCPCS L4050 · Replace molded calf lacer, for custom fabricated orthosis only

  • HCPCS L4060 · Replace high roll cuff


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”