L5150 — Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot
L5150 is a HCPCS Level II code for knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of L5150 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
- DME supplier
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for L5150
- Long descriptor
- Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot
- Short descriptor
- Mold sckt ext knee shin sach
- Added
- January 1, 1982
- BETOS
- D1F
- Pricing indicator
- 38 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Orthotics, prosthetics, prosthetic devices and vision services. Price subject to floors and ceilings.
Codes adjacent to L5150
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L5150 is not quite right, the correct code is very often within a few positions of it.
- L4631Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated
- L5000Partial foot, shoe insert with longitudinal arch, toe filler
- L5010Partial foot, molded socket, ankle height, with toe filler
- L5020Partial foot, molded socket, tibial tubercle height, with toe filler
- L5050Ankle, symes, molded socket, sach foot
- L5060Ankle, symes, metal frame, molded leather socket, articulated ankle/foot
- L5100Below knee, molded socket, shin, sach foot
- L5105Below knee, plastic socket, joints and thigh lacer, sach foot
- L5160Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot
- L5200Above knee, molded socket, single axis constant friction knee, shin, sach foot
- L5210Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each
- L5220Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each
- L5230Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot
- L5250Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot
- L5270Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot
- L5280Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot
Questions about L5150
What is HCPCS code L5150?
L5150 is a HCPCS Level II code for knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L5150?
The CMS HCPCS file marks L5150 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.