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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l2036-knee-ankle-foot-orthosis-full-plastic-double-upright
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    HCPCS L2036: Knee-Ankle-Foot Orthosis, Full Plastic, Double Upright

    HCPCS Level II code L2036 describes a custom-fabricated full-plastic knee-ankle-foot orthosis (KAFO) with double uprights, which may include a free-motion knee and/or free-motion ankle; service type is durable medical equipment fabrication and fitting, and the typical site of service is an orthotics/prosthetics clinic or specialized durable medical equipment provider setting where custom fabrication and fitting occur.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical Guideline, Durable Medical Equipment (DME): Bone Growth Stimulators Medical Guideline.

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with post-polio residual limb weakness and progressive knee instability is seen in an outpatient orthotics clinic after referral from a physiatrist. The patient reports recurrent knee buckling and ankle malalignment that limits community ambulation and increases fall risk. Clinical evaluation documents significant quadriceps weakness, knee hyperextension with gait, and ankle instability. An orthotist performs a comprehensive evaluation including range of motion, muscle strength testing, anthropometric measurements, and a gait assessment. A custom fabricated, full plastic knee-ankle-foot orthosis with double uprights (L2036) is prescribed to stabilize the knee and ankle, provide medial-lateral control, and allow for an optional free-motion knee hinge depending on the functional requirements.

    The clinical workflow includes: a referral and evaluation visit with the prescribing clinician, ordering the custom L2036 device, fabrication by a certified orthotic lab, a fitting appointment with alignment adjustments and patient education on donning/doffing and skin checks, and follow-up visits for gait training and progressive adjustments. Documentation includes a signed prescription specifying L2036, justification of custom fabrication, initial measurements, functional goals, and progress notes from follow-up visits documenting improvement in stability and ambulation distance.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic management and training, initial fitting of a prefabricated lower extremity orthosis, per hourMay be used for patient training in donning/doffing and ambulation when a prefabricated component is used in conjunction with L2036 activities
    97763Orthotic management and training, initial orthosis fitting and training, lower extremity, custom-fabricated, includes assessment and trainingUsed at the time of delivery for fitting and patient training specific to a custom-fabricated orthosis such as L2036
    97530Therapeutic activities, direct one-on-one patient contactUsed for functional gait training and strengthening sessions after delivery of L2036
    97750Physical performance test or measurementUsed for pre- and post-delivery functional outcome measurements (eg, gait speed, distance)
    99457Remote physiologic monitoring treatment management servicesMay be used for remote follow-up or monitoring of functional status after orthosis delivery

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    52Modifier ‑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…
    53Modifier 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…
    22Modifier –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…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    59Modifier 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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    231H00000XAudiologist(1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function.…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    2080P0208XPediatric Infectious Diseases PhysicianA pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific know…
    207ZI0100XImmunopathology PhysicianA pathologist who specializes in the diagnosis of immunologic diseases.
    246ZB0500XBiochemistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    1835E0208XEmergency Medicine PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in the care for patients at the bedside in emergency medicine settings.

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 2

    3 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01

    Related Codes

    HCPCS-L0112-CRANIAL-CERVICAL-ORTHOSIS-CONGENITAL-TORTICOLLIS-CUSTOM

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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