HCPCS L1940: Ankle Foot Orthosis, Custom Fabricated

HCPCS Level II code L1940 describes a custom-fabricated ankle foot orthosis made of plastic or other material intended to provide structural support and alignment for the lower leg and foot; service type: custom orthotic fabrication and fitting; typical site of service: outpatient clinic, orthotics/prosthetics facility, or specialty durable medical equipment supplier where custom molding and adjustments are performed.

Customize your policy alerts

Sign up for hcpcs L1940 policy alerts

Get alerted when payer policies referencing L1940 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Explore openpayer tools

View all tools

HCPCS L1940: Ankle Foot Orthosis, Custom Fabricated

Customize your policy alerts

Sign up for hcpcs L1940 policy alerts

Get alerted when payer policies referencing L1940 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 62-year-old with diabetic peripheral neuropathy and progressive forefoot deformity who presents to an orthotics clinic for evaluation of gait instability, recurrent plantar ulceration, or ankle instability. After a physician or certified orthotist/orthotic fitter documents a focused history and physical exam, weight-bearing and gait assessment are performed. Measurements and a plaster or digital cast of the affected lower extremity are obtained. A custom-fabricated ankle-foot orthosis (L1940) is manufactured to provide ankle-foot support, offload high-pressure areas, correct alignment, and improve functional mobility. The patient returns for fitting, adjustments, and education on donning, doffing, skin inspection, and progressive wear schedule. Follow-up visits assess fit, skin integrity, function, and need for repairs or replacement. Typical site of service is an outpatient orthotics/prosthetics clinic, physician office, or outpatient rehabilitation facility. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for the initial evaluation and follow-up visits documenting medical necessity and adjustments for a custom AFO
`97760`	Orthotic(s) management and training, upper extremity, lower extremity and/or trunk, initial orthotic fit; total time varies	Billed for patient training and education on use and care of the AFO during fitting visits
`99070`	Supplies and materials provided by the physician or supplier over and above those usually included with the office visit	May be used to bill for additional non-standard supplies provided at fitting (payer rules vary)
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider	Physical therapy activities related to gait training while the patient is using the custom AFO
`A9270`	Orthotic supply; replacement parts, not otherwise specified (HCPCS Level II)	Used when ordering replacement components or accessories for the custom AFO in later care

Related Modifiers

5 rows

Modifier	Description	When to Use
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
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…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
93	Modifier 93 denotes that a billed service was delivered synchronously via audio-only telecommunications (real-time telephone or other audio-only system). The AMA added modifier 93 in CPT Appendix A…	- When to use: Apply modifier -93 when a synchronous, real-time, two-way patient–provider encounter is conducted entirely via audio-only (telephone or other real-time interactive audio-only…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
173C00000X	Reflexologist	Reflexologists perform a non-invasive complementary modality involving thumb and finger techniques to apply alternating pressure to the reflexes withi…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
2472V0600X	Veterinary Technician	None
174400000X	Specialist	An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
373H00000X	Day Training/Habilitation Specialist	Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills t…
291U00000X	Clinical Medical Laboratory	(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, c…
207RC0200X	Critical Care Medicine (Internal Medicine) Physician	An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for…

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

HCPCS Level II L0170: Cervical Collar, Custom-Molded

HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

Showing 1–10 of 466

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.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Used for the initial evaluation and follow-up visits documenting medical necessity and adjustments for a custom AFO
`97760`	Orthotic(s) management and training, upper extremity, lower extremity and/or trunk, initial orthotic fit; total time varies	Billed for patient training and education on use and care of the AFO during fitting visits
`99070`	Supplies and materials provided by the physician or supplier over and above those usually included with the office visit	May be used to bill for additional non-standard supplies provided at fitting (payer rules vary)
`97530`	Therapeutic activities, direct (one-on-one) patient contact by the provider	Physical therapy activities related to gait training while the patient is using the custom AFO
`A9270`	Orthotic supply; replacement parts, not otherwise specified (HCPCS Level II)	Used when ordering replacement components or accessories for the custom AFO in later care

Related Modifiers

5 rows

Modifier	Description	When to Use
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
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…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
93	Modifier 93 denotes that a billed service was delivered synchronously via audio-only telecommunications (real-time telephone or other audio-only system). The AMA added modifier 93 in CPT Appendix A…	- When to use: Apply modifier -93 when a synchronous, real-time, two-way patient–provider encounter is conducted entirely via audio-only (telephone or other real-time interactive audio-only…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
173C00000X	Reflexologist	Reflexologists perform a non-invasive complementary modality involving thumb and finger techniques to apply alternating pressure to the reflexes withi…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
2472V0600X	Veterinary Technician	None
174400000X	Specialist	An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
373H00000X	Day Training/Habilitation Specialist	Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills t…
291U00000X	Clinical Medical Laboratory	(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, c…
207RC0200X	Critical Care Medicine (Internal Medicine) Physician	An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for…

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

HCPCS Level II L0170: Cervical Collar, Custom-Molded

HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

Showing 1–10 of 466

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.

OpenPayer

HCPCS L1940: Ankle Foot Orthosis, Custom Fabricated

Sign up for hcpcs L1940 policy alerts

OpenPayer

HCPCS L1940: Ankle Foot Orthosis, Custom Fabricated

Sign up for hcpcs L1940 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

HCPCS L1940: Ankle Foot Orthosis, Custom Fabricated

Sign up for hcpcs L1940 policy alerts

HCPCS L1940: Ankle Foot Orthosis, Custom Fabricated

Sign up for hcpcs L1940 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L1940 represent and where is it typically provided?

Which modifiers are appropriate to append to L1940 and when are they used?

What other procedure or supply codes are commonly billed alongside L1940?

For which diagnoses and clinical scenarios is a custom AFO under L1940 typically used?

Which payers are mentioned for L1940 coverage and are there specific policy considerations to be aware of?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L1940 represent and where is it typically provided?

Which modifiers are appropriate to append to L1940 and when are they used?

What other procedure or supply codes are commonly billed alongside L1940?

For which diagnoses and clinical scenarios is a custom AFO under L1940 typically used?

Which payers are mentioned for L1940 coverage and are there specific policy considerations to be aware of?

References