L4130 HCPCS Level II code: Replace pretibial shell
L4130 is the HCPCS code for “Replace pretibial shell” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
L4130Replace pretibial shell
HCPCS · United States
Medicare details
The indicators CMS publishes with L4130 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, 1984
Where L4130 sits
- 1L codesOrthotics and prosthetics
- 2Active code L4130Replace pretibial shell
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 L4130 mean?
L4130 is the HCPCS code for “Replace pretibial shell” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover L4130?
CMS lists L4130’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 L4130
All L codesL4060Replace high roll cuffL4070Replace proximal and distal upright for kafoL4080Replace metal bands kafo, proximal thighL4090Replace metal bands kafo-afo, calf or distal thighL4100Replace leather cuff kafo, proximal thighL4110Replace leather cuff kafo-afo, calf or distal thighL4205Repair of orthotic device, labor component, per 15 minutesL4210Repair of orthotic device, repair or replace minor partsL4350Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelfL4360Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise…L4361Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelfL4370Pneumatic full leg splint, prefabricated, off-the-shelf