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L4396 Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
BackL4000Replace girdle for spinal orthosis (ctlso or so)→L4002Replacement strap, any orthosis, includes all components, any length, any type→L4010Replace trilateral socket brim→L4020Replace quadrilateral socket brim, molded to patient model→L4030Replace quadrilateral socket brim, custom fitted→L4040Replace molded thigh lacer, for custom fabricated orthosis only→L4045Replace non-molded thigh lacer, for custom fabricated orthosis only→L4050Replace molded calf lacer, for custom fabricated orthosis only→L4055Replace non-molded calf lacer, for custom fabricated orthosis only→L4060Replace high roll cuff→L4070Replace proximal and distal upright for kafo→L4080Replace metal bands kafo, proximal thigh→L4090Replace metal bands kafo-afo, calf or distal thigh→L4100Replace leather cuff kafo, proximal thigh→L4110Replace leather cuff kafo-afo, calf or distal thigh→L4130Replace pretibial shell→L4205Repair of orthotic device, labor component, per 15 minutes→L4210Repair of orthotic device, repair or replace minor parts→L4350Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf→L4360Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise→L4361Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf→L4370Pneumatic full leg splint, prefabricated, off-the-shelf→L4386Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise→L4387Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf→L4392Replacement, soft interface material, static afo→L4394Replace soft interface material, foot drop splint→L4396Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise→L4397Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf→L4398Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf→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→
Procedure codeCODABLE
L4396
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
- Part
- HCPCS Level II
- L
- Orthotic and Prosthetic Procedures and Devices
- L4
- L4000–L4631
Source
CMS — ICD-10-PCS FY2026, HCPCS Level II october 2026, Procedure Codes 2026.