L5500 HCPCS Level II code: Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
L5500 is the HCPCS code for “Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
L5500Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
Short description: Init bk ptb plaster direct
HCPCS · United States
Medicare details
The indicators CMS publishes with L5500 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, 1986
Where L5500 sits
- 1L codesOrthotics and prosthetics
- 2Active code L5500Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed
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 L5500 mean?
L5500 is the HCPCS code for “Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover L5500?
CMS lists L5500’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 L5500
All L codesL5400Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below kneeL5410Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and…L5420Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulationL5430Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change…L5450Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below kneeL5460Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above kneeL5505Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formedL5510Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to modelL5520Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formedL5530Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to modelL5535Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socketL5540Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model