Key facts for L2320
- Medicare payment
- $236.44 to $315.25
- DMEPOS non-rural state fees
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- DME supplier MUE
- 2
- MAI 3
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 2 / 0
TL;DR
HCPCS Level II L2320 reads "Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only" in the October 2026 file; it dates from 1986. DMEPOS fees for L2320, a PO (prosthetics and orthotics) item, run $236.44 in AL, DC, DE and 11 more to $315.25 in AZ, CA, NV (floor $236.44, ceiling $315.25) in the October 2026 file. Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 3, Anatomic Consideration); DME supplier 2 (MAI 3, Anatomic Consideration). 2 active LCDs list L2320: L33318 (Knee Orthoses), L33686 (Ankle-Foot/Knee-Ankle-Foot Orthosis). OPPS status indicator A: Services not paid under OPPS; paid under fee schedule or other payment system. HCPCS record: BETOS D1F (prosthetic/orthotic devices); pricing indicator 38; type of service P (lump-sum purchase of DME, prosthetics or orthotics). 109 other active codes open with "Addition to lower extremity"; related codes: L2330, L2300, L2340, L2350.
L2320 descriptor and code status
The October 2026 HCPCS Level II file describes L2320 as “Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only”. It sits in the L section (orthotic and prosthetic procedures and devices), listed with the other L codes.
| Field | Value |
|---|---|
| Short descriptor | Non-molded lacer |
| Added to HCPCS | 1986-01-01 |
| Last action | N (no maintenance), effective 2005-01-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 38: DMEPOS orthotics, prosthetics, prosthetic devices and vision services (floors and ceilings) |
| BETOS category | D1F: prosthetic/orthotic devices |
| Type of service | P: lump-sum purchase of DME, prosthetics or orthotics |
Medicare payment for L2320
DMEPOS fees for L2320, a PO (prosthetics and orthotics) item, run $236.44 in AL, DC, DE and 11 more to $315.25 in AZ, CA, NV (floor $236.44, ceiling $315.25) in the October 2026 file. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.
DMEPOS fee schedule (DME26-D)
Jurisdiction D (DME MAC), payment category PO (prosthetics and orthotics). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.
| Modifier | Floor / ceiling | Non-rural state range | Rural range | AK / HI / PR / VI |
|---|---|---|---|---|
| none | $236.44 / $315.25 | $236.44 (AL, DC, DE…) to $315.25 (AZ, CA, NV) | — | AK $304.90, HI $325.94, PR $255.56, VI $283.00 |
Hospital outpatient (OPPS Addendum B)
Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.
Medically Unlikely Edits for L2320
Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 3, Anatomic Consideration); DME supplier 2 (MAI 3, Anatomic Consideration). The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
| Facility outpatient hospital | 2 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
| DME supplier | 2 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
The MUE lookup for L2320 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists L2320 in v323r0.
L2320 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.
Pair counts show exposure, not the answer for one claim. Check L2320 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for L2320
2 active Local Coverage Determinations and 0 billing and coding articles list L2320. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- Knee Orthoses, LCD L33318 · CGS Administrators, LLC; Noridian Healthcare Solutions, LLC
- Ankle-Foot/Knee-Ankle-Foot Orthosis (L33686) · CGS Administrators, LLC; Noridian Healthcare Solutions, LLC
Denials to expect on L2320
the diagnosis or documentation does not meet the LCD or billing article that lists L2320
the modifier reported is inconsistent with the code
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for L2320 claims
QuickAuth coordinates the requirement checks and documentation that DME claims for L2320 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.
Frequently asked questions: HCPCS L2320
What does HCPCS code L2320 describe?
"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only" (short descriptor "Non-molded lacer"), in the L section (orthotic and prosthetic procedures and devices). Added 1986-01-01; last action N (no maintenance) effective 2005-01-01.
Is L2320 a CPT code?
No. L2320 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.
What does Medicare pay for L2320?
DMEPOS fees for L2320, a PO (prosthetics and orthotics) item, run $236.44 in AL, DC, DE and 11 more to $315.25 in AZ, CA, NV (floor $236.44, ceiling $315.25) in the October 2026 file.
How many units of L2320 can be billed per day?
Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 2 (MAI 3, Anatomic Consideration); DME supplier 2 (MAI 3, Anatomic Consideration). For the DME supplier MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover L2320?
Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 2 active LCDs list L2320: L33318 (Knee Orthoses), L33686 (Ankle-Foot/Knee-Ankle-Foot Orthosis).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- DMEPOS fee schedule DME26-D, October 2026Version DME26-D (October 2026) · effective 2026-10-01 · file DMEPOS_OCT.csvSHA-256 a2824d58aadf4004…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
Disclaimer
This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.