2025 HCPCS Code L4055

Replace non-molded calf lacer, for custom fabricated orthosis only

TAGS: fabricated orthosis custom replace

Short Description	Replace non-molded calf lace
HCPCS Action Code	N - No maintenance for this code
HCPCS Coverage Code	C - Carrier judgment
HCPCS Code Added Date	January 01, 1988
HCPCS Action Effective Date	January 01, 2005
HCPCS Pricing Indicator Code	38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
HCPCS Type Of Service Code	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Coverage Issues Manual Reference Section Number