HCPCS Range Ankle and/or Foot Prosthetics and Additions

• 1 Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature ( L5968 )

• 2 Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s) ( L5969 )

• 3 All lower extremity prostheses, foot, external keel, solid ankle cushion heel (SACH) foot ( L5970 )

• 4 All lower extremity prosthesis, solid ankle cushion heel (SACH) foot, replacement only ( L5971 )

• 5 All lower extremity prostheses, foot, flexible keel ( L5972 )

• 6 Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source ( L5973 )

• 7 All lower extremity prostheses, foot, single axis ankle/foot ( L5974 )

• 8 All lower extremity prosthesis, combination single axis ankle and flexible keel foot ( L5975 )

• 9 All lower extremity prostheses, energy storing foot (seattle carbon copy II or equal) ( L5976 )

• 10 All lower extremity prostheses, foot, multiaxial ankle/foot ( L5978 )

• 11 All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system ( L5979 )

• 12 All lower extremity prostheses, flex foot system ( L5980 )

• 13 All lower extremity prostheses, flex-walk system or equal ( L5981 )

• 14 All exoskeletal lower extremity prostheses, axial rotation unit ( L5982 )

• 15 All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability ( L5984 )

• 16 All endoskeletal lower extremity prostheses, dynamic prosthetic pylon ( L5985 )

• 17 All lower extremity prosthesis, shank foot system with vertical loading pylon ( L5987 )

• 18 Addition to lower limb prosthesis, vertical shock reducing pylon feature ( L5988 )

• 19 Addition to lower extremity prosthesis, user adjustable heel height ( L5990 )

• 20 Lower extremity prosthesis, not otherwise specified ( L5999 )

• 21 All lower extremity prostheses, multi-axial rotation unit ('MCP' or equal) ( L5986 )

• 22 Addition to lower extremity prostheses, osseointegrated external prosthetic connector ( L5991 )