LCodeLookup B2B O&P Intelligence

2026 CMS DMEPOS Medicare & Multi-State Fee Schedule Intelligence

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LCodeLookup • Clinical Fee Schedule Summary

Official Statutory CMS DMEPOS & Multi-State Fee Schedule Intelligence

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Verified Medical Coding, RCM & Standard Written Order (SWO) Reference Document • https://lcodelookup.com

• Statutory Sitemap • Official CMS DMEPOS Source

Statutory Compliance Notice: HCPCS Level II procedure codes, nomenclature, and statutory descriptors are published by the Centers for Medicare & Medicaid Services (CMS). Fee schedules reflect 2026 CMS DMEPOS and state Medicaid statutory benchmarks. This platform serves as an administrative and clinical pricing reference and does not replace formal Local Coverage Determinations (LCDs) or guarantee claim adjudication. Consult your regional DME MAC (Noridian / CGS) and state Medicaid manuals for binding billing policies.

🧭 2026 O&P Clinical Category Directory

Explore all 905 statutory Orthotic & Prosthetic HCPCS Level II codes by clinical specialty:

Spinal Orthoses (L0100 - L0999) 82 Codes

Cervical collars, halo, TLSO, and LSO sagittal-coronal braces (e.g. L0637, L0650).

Scoliosis Orthoses (L1000 - L1499) 33 Codes

Milwaukee, Boston, Wilmington, Charleston night-bending frames & spinal jackets (e.g. L1000, L1200).

Lower Extremity Orthoses (L1500 - L2999) 165 Codes

Custom AFO, KAFO, knee braces, articulating ankle joints, and fracture bracing (e.g. L1960, L1843).

Foot & Upper Limb Orthoses (L3000 - L3999) 152 Codes

Custom functional inserts, UCBL, diabetic shoes, WHO wrist-hand-finger braces (e.g. L3000, L3806).

Walking Boots & Prefab (L4000 - L4999) 30 Codes

Pneumatic & non-pneumatic custom-fitted vs OTS walking boots (e.g. L4360, L4361, L4386).

Lower Limb Prosthetics (L5000 - L5999) 189 Codes

Transtibial/transfemoral bases, dynamic response feet, and microproc knees (e.g. L5981, L5856).

Upper Limb Prosthetics (L6000 - L6999) 131 Codes

Below-elbow, above-elbow, myoelectric terminal devices, and robotic hands (e.g. L6000, L6880).

Sockets, Liners & Suspension 49 Codes

Test sockets, carbon reinforcement, silicone suction liners, and suspension (e.g. L5620, L5673, L8400).

Mastectomy & Craniofacial (L8000 - L8049) 17 Codes

Silicone breast prostheses, mastectomy bras, and nasal/orbital/auricular facial prostheses (e.g. L8000, L8030, L8040).

Speech, Implants & Robotic (L8500 - L9900) 57 Codes

Tracheostoma voice prostheses, cochlear processors, MyoPro robotic orthoses, and statutory supplies (e.g. L8500, L8619, L8701, L9900).

ℹ️ Looking for general DME or clinical supplies? The main search bar also indexes 1,431 Medicare DMEPOS E & A codes (wheelchairs, CPAP, hospital beds, ostomy).

905 Statutory L-Codes

👑 Clinic Pro & Founder Access

Active View Mode: Visitor Mode

Switch between Founder Mode (all enterprise tools & estimators unlocked) and Visitor Mode (standard clinical lookups).

Feature Availability (Community Free vs. Clinic Pro):

50-State Statutory Medicare Rates

All 50 states, K-levels, LCD crosswalk alerts

Always Free (Public)

Multi-Code Estimate Assembly Tray

Bundle base socket + foot + knee + liners

Clinic Pro

Commercial Payer Multipliers

Oxford, Empire BCBS, Aetna % contracted rates

Clinic Pro

80/20 Co-insurance Split & GFE Printout

Patient out-of-pocket & branded estimate PDF

Clinic Pro

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Multi-Code Patient Estimate & GFE Builder Clinic Pro

Bundle component codes, calculate commercial multipliers, and model 80/20 patient co-insurance.

Clinical Print Options L-Code

Generate single-payer compliant documentation for charts, MD signatures, or audits.

Select Target Payer Document (Single-Payer Isolation)

Medicare Part B Clinical Chart Sheet (Recommended) SWO Ready

CMS DMEPOS statutory allowable, 80/20 coinsurance breakdown, ceiling/floor, and physician order sign-off. Completely excludes Medicaid & commercial rates to prevent payer down-pricing.

State Medicaid Fee Schedule Sheet Medicaid Active

State-specific statutory allowable, prior authorization codes, and maximum quantity limits. Excludes federal Medicare and commercial rates.

Commercial / Private Payer Estimate Contracted

Contracted rate estimate and estimated patient coinsurance for private plans.

Internal Practice Financial Audit (Clinic Pro) Confidential

Full multi-payer matrix showing CMS vs Medicaid spread and commercial multipliers. Automatically stamped with bold red proprietary watermark ("NOT FOR PATIENT CHART OR PAYER SUBMISSION").

Include Applicable LCD Addition Codes Checklist (0 additions) Include Standard Written Order (SWO) & Physician Signature Block

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You're an active clinical user! While LCodeLookup is in early access preview, you can test drive Founder Mode to get 100% full, unlimited access across all clinical intelligence tools.

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✓ Unlimited Inquiries: No hourly or daily limits

✓ Multi-Code Estimate Tray: Bundle base sockets, feet & additions

✓ Commercial Payer Multipliers: Contracted commercial rates

✓ Patient Co-insurance GFE: 80/20 splits & printouts

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