L5972 — All lower extremity prostheses, foot, flexible keel
L5972 is a HCPCS Level II code for all lower extremity prostheses, foot, flexible keel. 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 L5972 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 L5972
- Long descriptor
- All lower extremity prostheses, foot, flexible keel
- Short descriptor
- Flexible keel foot
- Added
- January 1, 1989
- 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 L5972
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L5972 is not quite right, the correct code is very often within a few positions of it.
- L5961Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control
- L5962Addition, endoskeletal system, below knee, flexible protective outer surface covering system
- L5964Addition, endoskeletal system, above knee, flexible protective outer surface covering system
- L5966Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system
- L5968Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature
- L5969Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s)
- L5970All lower extremity prostheses, foot, external keel, sach foot
- L5971All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only
- L5973Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source
- L5974All lower extremity prostheses, foot, single axis ankle/foot
- L5975All lower extremity prosthesis, combination single axis ankle and flexible keel foot
- L5976All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)
- L5978All lower extremity prostheses, foot, multiaxial ankle/foot
- L5979All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system
- L5980All lower extremity prostheses, flex foot system
- L5981All lower extremity prostheses, flex-walk system or equal
Questions about L5972
What is HCPCS code L5972?
L5972 is a HCPCS Level II code for all lower extremity prostheses, foot, flexible keel. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L5972?
The CMS HCPCS file marks L5972 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.