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HCPCS L9900 · Level II · orthotic and prosthetic code

L9900: Orthotic and prosthetic supply, accessory, 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); 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 NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for L9900

Medicare payment
none in these files
no PFS, DMEPOS, CLFS, OPPS or ASC amount; pricing indicator 46
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
DME supplier MUE
0
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
2 / 1

TL;DR

L9900 is a Level II code from the L section (orthotic and prosthetic procedures and devices), in use since 2000: "Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code". None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for L9900; its HCPCS pricing indicator is 46 (DMEPOS contractor-priced (not otherwise classified, individual determination or gap-filled)). MUE limits for L9900: DME supplier 0 (MAI 3, Code Descriptor / CPT Instruction). 2 active LCDs and 1 billing and coding article list L9900 across 7 states: L33318 (Knee Orthoses), L33737 (Eye Prostheses), A53708. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1F (prosthetic/orthotic devices); pricing indicator 46; type of service P (lump-sum purchase of DME, prosthetics or orthotics). Nearby codes: L8702, L8691, L8690, L8689.

L9900 descriptor and code status

The October 2026 HCPCS Level II file describes L9900 as “Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code”. It sits in the L section (orthotic and prosthetic procedures and devices), listed with the other L codes.

HCPCS file attributes of L9900
FieldValue
Short descriptorO&p supply/accessory/service
Added to HCPCS2000-01-01
Last actionN (no maintenance), effective 2000-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator46: DMEPOS contractor-priced (not otherwise classified, individual determination or gap-filled)
BETOS categoryD1F: prosthetic/orthotic devices
Type of serviceP: lump-sum purchase of DME, prosthetics or orthotics

Medicare payment for L9900

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for L9900; its HCPCS pricing indicator is 46 (DMEPOS contractor-priced (not otherwise classified, individual determination or gap-filled)). 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.

Hospital outpatient (OPPS Addendum B)

Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Ambulatory surgical center (Addendum BB)

Payment indicator N1 (Packaged service/item; no separate payment made).

Medically Unlikely Edits for L9900

MUE limits for L9900: DME supplier 0 (MAI 3, Code Descriptor / CPT Instruction). 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 L9900 by setting
SettingMUE (units/DOS)MAICMS rationale
DME supplier03 Date of Service Edit: ClinicalCode Descriptor / CPT Instruction

The MUE lookup for L9900 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists L9900 in v323r0.

L9900 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 L9900 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for L9900

2 active Local Coverage Determinations and 1 billing and coding article list L9900. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing L9900
ArticleTitleContractor(s)Related LCD
A53708Billing and Coding: External Components for Cochlear ImplantsPalmetto GBA—

Denials to expect on L9900

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists L9900

CARC 151 · N362

units of L9900 exceed the DME supplier MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for L9900 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for L9900 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS L9900

What does HCPCS code L9900 describe?

"Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs "l" code" (short descriptor "O&p supply/accessory/service"), in the L section (orthotic and prosthetic procedures and devices). Added 2000-01-01.

Is L9900 a CPT code?

No: CMS maintains L9900 in HCPCS Level II, while the AMA maintains CPT. People do search "L9900 CPT code", and it goes in the same procedure-code field.

What does Medicare pay for L9900?

None of the October 2026 PFS, DMEPOS, CLFS, OPPS or ASC files lists a national amount for L9900; its HCPCS pricing indicator is 46 (DMEPOS contractor-priced (not otherwise classified, individual determination or gap-filled)).

How many units of L9900 can be billed per day?

MUE limits for L9900: DME supplier 0 (MAI 3, Code Descriptor / CPT Instruction). For the DME supplier MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover L9900?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 2 active LCDs and 1 billing and coding article list L9900 across 7 states: L33318 (Knee Orthoses), L33737 (Eye Prostheses), A53708.

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.