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HCPCS L4002 · Level II · orthotic and prosthetic code

L4002: Replacement strap, any orthosis, includes all components, any length, any type, HCPCS Level II orthotic and prosthetic code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for L4002

Medicare payment
no DMEPOS fee
DMEPOS category PO, no ceiling or state fee; OPPS SI A: paid under another fee schedule or system
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
8
MAI 3
OPPS status
SI A
Services not paid under OPPS; paid under fee schedule or other payment system
NCCI PTP pairs
0
practitioner file
LCDs and articles
3 / 0

TL;DR

L4002 is a Level II code from the L section (orthotic and prosthetic procedures and devices), in use since 2005: "Replacement strap, any orthosis, includes all components, any length, any type". The October 2026 DMEPOS fee schedule lists L4002 in category PO (prosthetics and orthotics) without a ceiling, floor or state fee; its HCPCS pricing indicator is 38 (DMEPOS orthotics, prosthetics, prosthetic devices and vision services (floors and ceilings)). Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays L4002 under a fee schedule or payment system other than OPPS. CMS caps L4002 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 4 (MAI 3, Clinical: Data); DME supplier 8 (MAI 3, Clinical: Data) units per day in the 2026 Q4 MUE tables. 3 active LCDs list L4002: L33318 (Knee Orthoses), L33686 (Ankle-Foot/Knee-Ankle-Foot Orthosis). HCPCS record: BETOS D1F (prosthetic/orthotic devices); pricing indicator 38; type of service P (lump-sum purchase of DME, prosthetics or orthotics). Nearby codes: L4000, L3999, L3995, L3984.

L4002 descriptor and code status

The October 2026 HCPCS Level II file describes L4002 as “Replacement strap, any orthosis, includes all components, any length, any type”. It sits in the L section (orthotic and prosthetic procedures and devices), listed with the other L codes.

HCPCS file attributes of L4002
FieldValue
Short descriptorReplace strap, any orthosis
Added to HCPCS2005-01-01
Last actionN (no maintenance), effective 2005-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator38: DMEPOS orthotics, prosthetics, prosthetic devices and vision services (floors and ceilings)
BETOS categoryD1F: prosthetic/orthotic devices
Type of serviceP: lump-sum purchase of DME, prosthetics or orthotics

Medicare payment for L4002

The October 2026 DMEPOS fee schedule lists L4002 in category PO (prosthetics and orthotics) without a ceiling, floor or state fee; its HCPCS pricing indicator is 38 (DMEPOS orthotics, prosthetics, prosthetic devices and vision services (floors and ceilings)). Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays L4002 under a fee schedule or payment system other than OPPS. 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.

DMEPOS fees for L4002 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
none————

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 L4002

CMS caps L4002 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 4 (MAI 3, Clinical: Data); DME supplier 8 (MAI 3, Clinical: Data) units per day in the 2026 Q4 MUE tables. The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for L4002 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital43 Date of Service Edit: ClinicalClinical: Data
DME supplier83 Date of Service Edit: ClinicalClinical: Data

The MUE lookup for L4002 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists L4002 in v323r0.

L4002 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 L4002 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for L4002

3 active Local Coverage Determinations and 0 billing and coding articles list L4002. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on L4002

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists L4002

CARC 151 · N362

units of L4002 exceed the DME supplier MUE of 8 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for L4002 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for L4002 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS L4002

What does HCPCS code L4002 describe?

"Replacement strap, any orthosis, includes all components, any length, any type" (short descriptor "Replace strap, any orthosis"), in the L section (orthotic and prosthetic procedures and devices). Added 2005-01-01.

Is L4002 a CPT code?

It is not. L4002 belongs to the L section (orthotic and prosthetic procedures and devices) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for L4002?

The October 2026 DMEPOS fee schedule lists L4002 in category PO (prosthetics and orthotics) without a ceiling, floor or state fee; its HCPCS pricing indicator is 38 (DMEPOS orthotics, prosthetics, prosthetic devices and vision services (floors and ceilings)). Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays L4002 under a fee schedule or payment system other than OPPS.

How many units of L4002 can be billed per day?

CMS caps L4002 at practitioner 0 (MAI 3, CMS Policy); hospital outpatient 4 (MAI 3, Clinical: Data); DME supplier 8 (MAI 3, Clinical: Data) units per day in the 2026 Q4 MUE tables. For the DME supplier MUE (MAI 3), units above 8 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover L4002?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 3 active LCDs list L4002: 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.

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.