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L5658 Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
BackL5000Partial 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→L5150Knee disarticulation (or through knee), molded socket, external knee joints, shin, 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→L5301Below knee, molded socket, shin, sach foot, endoskeletal system→L5312Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system→L5321Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee→L5331Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot→L5341Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot→L5400Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee→L5410Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment→L5420Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation→L5430Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment→L5450Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee→L5460Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee→L5500Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed→L5505Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed→L5510Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model→L5520Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed→L5530Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model→L5535Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket→L5540Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model→L5560Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model→L5570Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed→L5580Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model→L5585Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket→L5590Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model→L5595Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model→L5600Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model→L5610Addition to lower extremity, endoskeletal system, above knee, hydracadence system→L5611Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control→L5613Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control→L5614Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control→L5615Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control→L5616Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control→L5617Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each→L5618Addition to lower extremity, test socket, symes→L5620Addition to lower extremity, test socket, below knee→L5622Addition to lower extremity, test socket, knee disarticulation→L5624Addition to lower extremity, test socket, above knee→L5626Addition to lower extremity, test socket, hip disarticulation→L5628Addition to lower extremity, test socket, hemipelvectomy→L5629Addition to lower extremity, below knee, acrylic socket→L5630Addition to lower extremity, symes type, expandable wall socket→L5631Addition to lower extremity, above knee or knee disarticulation, acrylic socket→L5632Addition to lower extremity, symes type, 'ptb' brim design socket→L5634Addition to lower extremity, symes type, posterior opening (canadian) socket→L5636Addition to lower extremity, symes type, medial opening socket→L5637Addition to lower extremity, below knee, total contact→L5638Addition to lower extremity, below knee, leather socket→L5639Addition to lower extremity, below knee, wood socket→L5640Addition to lower extremity, knee disarticulation, leather socket→L5642Addition to lower extremity, above knee, leather socket→L5643Addition to lower extremity, hip disarticulation, flexible inner socket, external frame→L5644Addition to lower extremity, above knee, wood socket→L5645Addition to lower extremity, below knee, flexible inner socket, external frame→L5646Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket→L5647Addition to lower extremity, below knee suction socket→L5648Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket→L5649Addition to lower extremity, ischial containment/narrow m-l socket→L5650Additions to lower extremity, total contact, above knee or knee disarticulation socket→L5651Addition to lower extremity, above knee, flexible inner socket, external frame→L5652Addition to lower extremity, suction suspension, above knee or knee disarticulation socket→L5653Addition to lower extremity, knee disarticulation, expandable wall socket→L5654Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)→L5655Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)→L5656Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)→L5657Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials→L5658Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)→L5661Addition to lower extremity, socket insert, multi-durometer symes→L5665Addition to lower extremity, socket insert, multi-durometer, below knee→L5666Addition to lower extremity, below knee, cuff suspension→L5668Addition to lower extremity, below knee, molded distal cushion→L5670Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)→L5671Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert→L5672Addition to lower extremity, below knee, removable medial brim suspension→L5673Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism→L5676Additions to lower extremity, below knee, knee joints, single axis, pair→L5677Additions to lower extremity, below knee, knee joints, polycentric, pair→L5678Additions to lower extremity, below knee, joint covers, pair→L5679Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism→L5680Addition to lower extremity, below knee, thigh lacer, nonmolded→L5681Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)→L5682Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded→L5683Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)→L5684Addition to lower extremity, below knee, fork strap→L5685Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each→L5686Addition to lower extremity, below knee, back check (extension control)→L5688Addition to lower extremity, below knee, waist belt, webbing→L5690Addition to lower extremity, below knee, waist belt, padded and lined→L5692Addition to lower extremity, above knee, pelvic control belt, light→L5694Addition to lower extremity, above knee, pelvic control belt, padded and lined→L5695Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each→L5696Addition to lower extremity, above knee or knee disarticulation, pelvic joint→L5697Addition to lower extremity, above knee or knee disarticulation, pelvic band→L5698Addition to lower extremity, above knee or knee disarticulation, silesian bandage→L5699All lower extremity prostheses, shoulder harness→L5700Replacement, socket, below knee, molded to patient model→L5701Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model→L5702Replacement, socket, hip disarticulation, including hip joint, molded to patient model→L5703Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only→L5704Custom shaped protective cover, below knee→L5705Custom shaped protective cover, above knee→L5706Custom shaped protective cover, knee disarticulation→L5707Custom shaped protective cover, hip disarticulation→L5710Addition, exoskeletal knee-shin system, single axis, manual lock→L5711Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material→L5712Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)→L5714Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control→L5716Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock→L5718Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control→L5722Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control→L5724Addition, exoskeletal knee-shin system, single axis, fluid swing phase control→L5726Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control→L5728Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control→L5780Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control→L5781Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system→L5782Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty→L5783Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)→L5785Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)→L5790Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)→L5795Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)→L5810Addition, endoskeletal knee-shin system, single axis, manual lock→L5811Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material→L5812Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)→L5814Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock→L5816Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock→L5818Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control→L5822Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control→L5824Addition, endoskeletal knee-shin system, single axis, fluid swing phase control→L5826Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame→L5827Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping→L5828Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control→L5830Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control→L5840Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control→L5841Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control→L5845Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable→L5848Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability→L5850Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist→L5855Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist→L5856Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type→L5857Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type→L5858Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type→L5859Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)→L5910Addition, endoskeletal system, below knee, alignable system→L5920Addition, endoskeletal system, above knee or hip disarticulation, alignable system→L5925Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock→L5926Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type→L5930Addition, endoskeletal system, high activity knee control frame→L5940Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)→L5950Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)→L5960Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)→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→L5972All lower extremity prostheses, foot, flexible keel→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→L5982All exoskeletal lower extremity prostheses, axial rotation unit→L5984All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability→L5985All endoskeletal lower extremity prostheses, dynamic prosthetic pylon→L5986All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal)→L5987All lower extremity prosthesis, shank foot system with vertical loading pylon→L5988Addition to lower limb prosthesis, vertical shock reducing pylon feature→L5990Addition to lower extremity prosthesis, user adjustable heel height→L5991Addition to lower extremity prostheses, osseointegrated external prosthetic connector→L5992All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only→L5999Lower extremity prosthesis, not otherwise specified→
Procedure codeCODABLE
L5658
Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)
- Part
- HCPCS Level II
- L
- Orthotic and Prosthetic Procedures and Devices
- L5
- L5000–L5999
Source
CMS — ICD-10-PCS FY2026, HCPCS Level II october 2026, Procedure Codes 2026.