L1904 HCPCS Level II code: Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
L1904 is the HCPCS code for “Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
L1904Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
Short description: Afo molded ankle gauntlet
HCPCS · United States
Medicare details
The indicators CMS publishes with L1904 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Medicare pricing
- DMEPOS fee schedule – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
- Type of service
- Lump sum purchase of DME, prosthetics, orthotics
- BETOS category
- Prosthetic/Orthotic devices
- Added
- Jan 1, 1988
Where L1904 sits
- 1L codesOrthotics and prosthetics
- 2Active code L1904Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code L1904 mean?
L1904 is the HCPCS code for “Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover L1904?
CMS lists L1904’s Medicare coverage as “Carrier judgment” and its pricing as “DMEPOS fee schedule – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside L1904
All L codesL1850Knee orthosis, swedish type, prefabricated, off-the-shelfL1851Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without…L1852Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without…L1860Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)L1900Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricatedL1902Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelfL1906Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelfL1907Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricatedL1910Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustmentL1920Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricatedL1930Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustmentL1932Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise…