L2128 — Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated
L2128 is a HCPCS Level II code for knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated. 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 L2128 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 L2128
- Long descriptor
- Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated
- Short descriptor
- Kafo fem fx cast molded to p
- Added
- January 1, 1988
- 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 L2128
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L2128 is not quite right, the correct code is very often within a few positions of it.
- L2080Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated
- L2090Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated
- L2106Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated
- L2108Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated
- L2112Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment
- L2114Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment
- L2116Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment
- L2126Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated
- L2132Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment
- L2134Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment
- L2136Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment
- L2180Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints
- L2182Addition to lower extremity fracture orthosis, drop lock knee joint
- L2184Addition to lower extremity fracture orthosis, limited motion knee joint
- L2186Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type
- L2188Addition to lower extremity fracture orthosis, quadrilateral brim
Questions about L2128
What is HCPCS code L2128?
L2128 is a HCPCS Level II code for knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L2128?
The CMS HCPCS file marks L2128 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.