HCPCS Codes for Lump sum purchase of DME, prosthetics, orthotics


  • L5341

    Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot
  • L5400

    Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee
  • L5410

    Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment
  • L5420

    Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation
  • L5430

    Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment
  • L5450

    Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee
  • L5460

    Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee
  • L5500

    Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
  • L5505

    Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
  • L5510

    Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model
  • L5520

    Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed
  • L5530

    Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model
  • L5535

    Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket
  • L5540

    Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model
  • L5560

    Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model
  • L5570

    Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed
  • L5580

    Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model
  • L5585

    Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket
  • L5590

    Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model
  • L5595

    Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model
  • L5600

    Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model
  • L5610

    Addition to lower extremity, endoskeletal system, above knee, hydracadence system
  • L5611

    Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control
  • L5613

    Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control
  • L5614

    Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control
  • L5615

    Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control
  • L5616

    Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control
  • L5617

    Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each
  • L5618

    Addition to lower extremity, test socket, symes
  • L5620

    Addition to lower extremity, test socket, below knee
  • L5622

    Addition to lower extremity, test socket, knee disarticulation
  • L5624

    Addition to lower extremity, test socket, above knee
  • L5626

    Addition to lower extremity, test socket, hip disarticulation
  • L5628

    Addition to lower extremity, test socket, hemipelvectomy
  • L5629

    Addition to lower extremity, below knee, acrylic socket
  • L5630

    Addition to lower extremity, symes type, expandable wall socket
  • L5631

    Addition to lower extremity, above knee or knee disarticulation, acrylic socket
  • L5632

    Addition to lower extremity, symes type, 'ptb' brim design socket
  • L5634

    Addition to lower extremity, symes type, posterior opening (canadian) socket
  • L5636

    Addition to lower extremity, symes type, medial opening socket
  • L5637

    Addition to lower extremity, below knee, total contact
  • L5638

    Addition to lower extremity, below knee, leather socket
  • L5639

    Addition to lower extremity, below knee, wood socket
  • L5640

    Addition to lower extremity, knee disarticulation, leather socket
  • L5642

    Addition to lower extremity, above knee, leather socket
  • L5643

    Addition to lower extremity, hip disarticulation, flexible inner socket, external frame
  • L5644

    Addition to lower extremity, above knee, wood socket
  • L5645

    Addition to lower extremity, below knee, flexible inner socket, external frame
  • L5646

    Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket
  • L5647

    Addition to lower extremity, below knee suction socket