L1904 Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated

Short descriptor: Afo molded ankle gauntlet

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L1904 is the HCPCS Level II code for Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated (2026). It belongs to Section L — Orthotic & Prosthetic Procedures. Under Medicare, its coverage status is: Carrier judgment. Part B pricing methodology: Orthotics, prosthetics & vision services.

Classification & CMS Attributes

Medicare Coverage
Carrier judgment (code C)
Part B Pricing
Orthotics, prosthetics & vision services (indicator 38)
Type of Service
Lump-sum purchase of DME, prosthetics, orthotics
Effective Date
2016-01-01
2026 Maintenance
No change this year

References

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Reference L1904 with the canonical source and edition:

L1904 — Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated. ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/L1904

Canonical URL: https://icd10codingpro.com/hcpcs-codes/L1904

Related Codes in Section L

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Reviewed by Prajwal Shrestha, CPC, CRC
Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) · AAPC Member ID 01997614 · About · Editorial policy · Content last reviewed: 2026-01-01

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