HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

HCPCS Level II code K0902 describes a prefabricated, off-the-shelf knee orthosis (KO), double upright with thigh and calf support and an adjustable flexion/extension joint (unicentric or polycentric) providing medial-lateral and rotation control and optional varus/valgus adjustment; the service is the provision and fitting of a prefabricated off-the-shelf knee brace intended for ambulatory or outpatient orthopedic settings and durable medical equipment (DME) suppliers for patients needing knee stability and motion control.

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HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

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Get alerted when payer policies referencing K0902 are released or updated.

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with symptomatic knee instability or post-operative protection following ligament repair who presents to an orthotics clinic after referral from an orthopedic surgeon or physical therapist. The patient may have diagnoses such as a medial collateral ligament sprain, posterolateral corner injury, or proximal tibial fracture requiring a stabilized knee joint. The clinical workflow begins with an initial evaluation by an orthotist or orthopedic clinician to assess joint range of motion, laxity, swelling, and skin integrity. Measurements are taken for an off-the-shelf double upright knee orthosis with adjustable flexion/extension joints (K0902). The orthosis is sized and fitted in clinic; gait and functional checks are performed, and joint stops are set to prescribed flexion/extension limits. Patient education on donning/doffing, skin checks, and activity restrictions is provided. Follow-up visits occur to confirm fit, adjust joint settings (for example to gradually increase allowed flexion), and document functional progress. If the device cannot be fitted or requires customization, the orthotist documents reasons and communicates with the referring provider for next steps.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97760`	Orthotic(s) management and training, upper extremity, lower extremity, and/or trunk, initial fitting and education	Used for initial fitting and patient education when an orthotist or therapist trains the patient on use of the knee orthosis
`97763`	Orthotic(s) management and training, subsequent orthotic(s) fitting, and adjustment(s)	Used for follow-up visits to adjust joint settings, re-fit, or modify the off‑the‑shelf knee orthosis
`99202`	Office or other outpatient visit for the evaluation and management of a new patient, typically 15-29 minutes	Used when a new patient is evaluated by an orthopedist or physiatrist who prescribes the orthosis
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for follow-up evaluation related to orthosis use, wound or skin check, or adjustment needs
`20550`	Injection(s); single tendon sheath, or ligament, or ganglion cyst aspiration (when applicable)	Occasionally performed prior to orthosis fitting for symptomatic control (e.g., steroid injection) in related clinical workflows

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
24	Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…	- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
213EP0504X	Public Medicine Podiatrist	Podiatric Medicine & Surgery Service Providers · Podiatrist
2080C0008X	Child Abuse Pediatrics Physician	A Child Abuse Pediatrician serves as a resource to children, families and communities by accurately diagnosing abuse; consulting with community agenci…
261QH0100X	Health Service Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
2472B0301X	Biomedical Engineering Technician	None

Related ICD-10-CM Codes

21 rows

ICD-10-CM Code	Description
E11.621	Type 2 diabetes mellitus with foot ulcer
G57.61	Lesion of plantar nerve, right lower limb
M05.869	Other rheumatoid arthritis with rheumatoid factor of unspecified knee
M17.0	Bilateral primary osteoarthritis of knee
M17.11	Unilateral primary osteoarthritis, right knee
M17.12	Unilateral primary osteoarthritis, left knee
M17.2	Bilateral post-traumatic osteoarthritis of knee
M17.5	Other unilateral secondary osteoarthritis of knee
M17.9	Osteoarthritis of knee, unspecified
M23.201	Derangement of unspecified lateral meniscus due to old tear or injury, left knee

Showing 1–10 of 21

HCPCS Level II C1300: Hyperbaric Oxygen, Full‑Body Chamber, per 30 min

HCPCS-K0901-KNEE-ORTHOSIS-SINGLE-UPRIGHT-PREFABRICATED

HCPCS Level II K0901: Knee Orthosis, Single Upright, Prefabricated

HCPCS-K0903-DIABETIC-CUSTOM-MULTIPLE-DENSITY-INSERT

HCPCS K0903: Diabetic Custom Multi-density Total Contact Insert

HCPCS-K1001-ELECTRONIC-POSITIONAL-OSA-TREATMENT-SENSOR

HCPCS K1001: Electronic Positional Obstructive Sleep Apnea Treatment

HCPCS-K1002-CRANIAL-ELECTROTHERAPY-STIMULATION-SYSTEM

HCPCS K1002: Cranial Electrotherapy Stimulation System

HCPCS-K1003-WHIRLPOOL-TUB-WALK-IN-PORTABLE

HCPCS Level II K1003: Whirlpool Tub, Walk-In, Portable

HCPCS-LEVEL-II-M1144-LIMITED-CONSULTATIVE-THERAPY-1-2-VISITS

HCPCS Level II M1144: Ongoing Care Not Indicated, 1–2 Visits

HCPCS-M0064-PSYCHIATRIC-MEDICATION-MANAGEMENT-BRIEF-OFFICE-VISIT

HCPCS M0064: Brief Visit for Psychiatric Medication Monitoring

HCPCS-M1000-PAIN-SCREEN-MODERATE-SEVERE

HCPCS M1000: Pain Screened as Moderate to Severe

HCPCS-M1001-PAIN-MANAGEMENT-PLAN-OF-CARE-MODERATE-SEVERE-PAIN

HCPCS Level II M1001: Plan of Care for Moderate to Severe Pain

Showing 1–10 of 16

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97760`	Orthotic(s) management and training, upper extremity, lower extremity, and/or trunk, initial fitting and education	Used for initial fitting and patient education when an orthotist or therapist trains the patient on use of the knee orthosis
`97763`	Orthotic(s) management and training, subsequent orthotic(s) fitting, and adjustment(s)	Used for follow-up visits to adjust joint settings, re-fit, or modify the off‑the‑shelf knee orthosis
`99202`	Office or other outpatient visit for the evaluation and management of a new patient, typically 15-29 minutes	Used when a new patient is evaluated by an orthopedist or physiatrist who prescribes the orthosis
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for follow-up evaluation related to orthosis use, wound or skin check, or adjustment needs
`20550`	Injection(s); single tendon sheath, or ligament, or ganglion cyst aspiration (when applicable)	Occasionally performed prior to orthosis fitting for symptomatic control (e.g., steroid injection) in related clinical workflows

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
24	Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…	- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
208D00000X	General Practice Physician	A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
213EP0504X	Public Medicine Podiatrist	Podiatric Medicine & Surgery Service Providers · Podiatrist
2080C0008X	Child Abuse Pediatrics Physician	A Child Abuse Pediatrician serves as a resource to children, families and communities by accurately diagnosing abuse; consulting with community agenci…
261QH0100X	Health Service Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
2472B0301X	Biomedical Engineering Technician	None

Related ICD-10-CM Codes

21 rows

ICD-10-CM Code	Description
E11.621	Type 2 diabetes mellitus with foot ulcer
G57.61	Lesion of plantar nerve, right lower limb
M05.869	Other rheumatoid arthritis with rheumatoid factor of unspecified knee
M17.0	Bilateral primary osteoarthritis of knee
M17.11	Unilateral primary osteoarthritis, right knee
M17.12	Unilateral primary osteoarthritis, left knee
M17.2	Bilateral post-traumatic osteoarthritis of knee
M17.5	Other unilateral secondary osteoarthritis of knee
M17.9	Osteoarthritis of knee, unspecified
M23.201	Derangement of unspecified lateral meniscus due to old tear or injury, left knee

Showing 1–10 of 21

HCPCS Level II C1300: Hyperbaric Oxygen, Full‑Body Chamber, per 30 min

HCPCS-K0901-KNEE-ORTHOSIS-SINGLE-UPRIGHT-PREFABRICATED

HCPCS Level II K0901: Knee Orthosis, Single Upright, Prefabricated

HCPCS-K0903-DIABETIC-CUSTOM-MULTIPLE-DENSITY-INSERT

HCPCS K0903: Diabetic Custom Multi-density Total Contact Insert

HCPCS-K1001-ELECTRONIC-POSITIONAL-OSA-TREATMENT-SENSOR

HCPCS K1001: Electronic Positional Obstructive Sleep Apnea Treatment

HCPCS-K1002-CRANIAL-ELECTROTHERAPY-STIMULATION-SYSTEM

HCPCS K1002: Cranial Electrotherapy Stimulation System

HCPCS-K1003-WHIRLPOOL-TUB-WALK-IN-PORTABLE

HCPCS Level II K1003: Whirlpool Tub, Walk-In, Portable

HCPCS-LEVEL-II-M1144-LIMITED-CONSULTATIVE-THERAPY-1-2-VISITS

HCPCS Level II M1144: Ongoing Care Not Indicated, 1–2 Visits

HCPCS-M0064-PSYCHIATRIC-MEDICATION-MANAGEMENT-BRIEF-OFFICE-VISIT

HCPCS M0064: Brief Visit for Psychiatric Medication Monitoring

HCPCS-M1000-PAIN-SCREEN-MODERATE-SEVERE

HCPCS M1000: Pain Screened as Moderate to Severe

HCPCS-M1001-PAIN-MANAGEMENT-PLAN-OF-CARE-MODERATE-SEVERE-PAIN

HCPCS Level II M1001: Plan of Care for Moderate to Severe Pain

Showing 1–10 of 16

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

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HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

References

HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

Sign up for hcpcs K0902 policy alerts

HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

Sign up for hcpcs K0902 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What device and service does HCPCS code K0902 represent?

Which clinical conditions or patient scenarios commonly lead to use of a K0902 knee orthosis?

What CPT codes are commonly used alongside K0902 for fitting, training, and clinical visits?

How is follow‑up care and adjustments for a K0902 orthosis handled and documented?

Which payers are referenced for K0902 and where can I find coverage or payment details?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What device and service does HCPCS code K0902 represent?

Which clinical conditions or patient scenarios commonly lead to use of a K0902 knee orthosis?

What CPT codes are commonly used alongside K0902 for fitting, training, and clinical visits?

How is follow‑up care and adjustments for a K0902 orthosis handled and documented?

Which payers are referenced for K0902 and where can I find coverage or payment details?

References