L5999 — Lower extremity prosthesis, not otherwise specified
L5999 is a HCPCS Level II code for lower extremity prosthesis, not otherwise specified. 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 L5999 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 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
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 L5999
- Long descriptor
- Lower extremity prosthesis, not otherwise specified
- Short descriptor
- Lowr extremity prosthes nos
- Added
- January 1, 1982
- BETOS
- D1F
- Pricing indicator
- 46 — 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.
Carrier priced — not otherwise classified, individual determination, carrier discretion, or gap-filled amounts.
Codes adjacent to L5999
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L5999 is not quite right, the correct code is very often within a few positions of it.
- 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
- L6000Partial hand, thumb remainingterminated
- L6010Partial hand, little and/or ring finger remainingterminated
- L6020Partial hand, no finger remainingterminated
- L6025Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal deviceterminated
- L6026Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)
- L6028Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692
- L6029Upper extremity addition, test socket/interface, partial hand including fingers
- L6030Upper extremity addition, external frame, partial hand including fingers
Questions about L5999
What is HCPCS code L5999?
L5999 is a HCPCS Level II code for lower extremity prosthesis, not otherwise specified. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L5999?
The CMS HCPCS file marks L5999 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.