HCPCS Code L5657

Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials
Short DescriptionAdd low ext man aut vol any
Year2026
Coverage CodeC = Carrier judgment
Action CodeP = Payment change (MOG, pricing indicator codes, anesthesia base units, Ambulatory Surgical Centers)
Action Effective DateApril 01, 2026
Code Added DateOctober 01, 2025
Pricing Indicator38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Type of ServiceP = Lump sum purchase of DME, prosthetics, orthotics