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HCPCS Procedure & Supply Codes

Orthotic Devices & Services

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Orthotic Devices -- Lower Limb

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Knee Orthosis (KO)

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L1810   Knee orthosis, elastic with joints, prefabricated item that has been trimmed, be...
L1812   Knee orthosis, elastic with joints, prefabricated, off-the-shelf
L1820   Knee orthosis, elastic with condylar pads and joints, with or without patellar c...
L1830   Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf
L1831   Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includ...
L1832   Knee orthosis, adjustable knee joints (unicentric or polycentric), positional or...
L1833   Knee orthosis, adjustable knee joints (unicentric or polycentric), positional or...
L1834   Knee orthosis, without knee joint, rigid, custom fabricated
L1836   Knee orthosis, rigid, without joint(s), includes soft interface material, prefab...
L1840   Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fa...
L1843   Knee orthosis, single upright, thigh and calf, with adjustable flexion and exten...
L1844   Knee orthosis, single upright, thigh and calf, with adjustable flexion and exten...
L1845   Knee orthosis, double upright, thigh and calf, with adjustable flexion and exten...
L1846   Knee orthosis, double upright, thigh and calf, with adjustable flexion and exten...
L1847   Knee orthosis, double upright with adjustable joint, with inflatable air support...
L1848   Knee orthosis, double upright with adjustable joint, with inflatable air support...
L1850   Knee orthosis, swedish type, prefabricated, off-the-shelf
L1851   Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and ...
L1852   Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and ...
L1860   Knee orthosis, modification of supracondylar prosthetic socket, custom fabricate...
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