L2850 Femoral lgth sock fx or equa

Addition to lower extremity orthosis, femoral length sock, fracture or equal, each

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for L2850

DMEPOS fee schedule, July 2026 (DME26-C)

Payer policies and prior authorization for L2850

3 of 3 payer prior-auth lists that name L2850 require prior authorization or set conditions: Blue Shield of California Promise Health Plan, UnitedHealthcare.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of California Promise Health PlanPromise Health Plan Medi-CalCAprior auth requiredSep 1, 2026Medi-Cal Prior Authorization List
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Individual Exchange plansAllprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026

Payer coverage policies that name L2850

L2850 appears in 4 coverage policies from Aetna, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaAnkle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot Orthoses (KAFOs) (0565)covered if criteria are metAug 26, 2026payer document
AetnaKnee Braces (1094)covered if criteria are metJan 20, 2026payer document
AetnaOrthopedic Casts, Braces and Splints (0009)listed, no stance (range L1600-L2999)Jan 20, 2026payer document
CignaOrthotic Devices and Shoes (0543)covered if criteria are metSep 15, 2026payer document

Recent prior-auth changes

  • May 1, 2026: conditions changed, UnitedHealthcare
  • Apr 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Apr 1, 2026: conditions changed, UnitedHealthcare

Medicaid fee-for-service

Prior authorization required or conditional in LA, MA, MS, NY, VA, WV.

  • AZ: $72.07 (dme), effective Oct 1, 2026
  • CO: $62.69 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $31.22 (dme), effective Jul 1, 2026
  • IL: $56.46 (dme), effective Jan 1, 2026
  • IN: $61.95 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KS: $75.89 (default), effective Jul 1, 2026
  • KY: $44.46 (dme), effective Jan 1, 2026
  • LA: $41.55 (dme), effective Jul 1, 2012
  • MA: $69.70 (orthotics_prosthetics_rates), effective Apr 1, 2024
  • MD: $60.48 (dme), effective Apr 1, 2026
  • MS: $56.92 (comprehensive), effective Jul 1, 2026
  • ND: $96.72 (dme), effective Aug 1, 2026
  • NE: $81.45 (dme), effective Jul 1, 2026
  • NY: $40.40 (dme), effective Jul 1, 2026
  • OH: $38.64 (dme), effective Jan 1, 2010
  • OK: $53.59 (dme), effective Jan 1, 2026
  • TX: $46.09 (dmepos_tos_9_e_j_l_and_r, Hospital - Long Term, Limited, Or Specialized Ca, facility), effective Apr 1, 1992
  • VA: $64.04 (dme), effective Dec 1, 2026
  • VT: $76.35 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $53.47 (prosthetics_orthotics), effective Jul 1, 2026
  • WY: $56.26 (professional), effective Jan 1, 2021

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.