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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l4360-pneumatic-vacuum-walking-boot-prefabricated-customized
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    HCPCS Level II L4360: Pneumatic/Vacuum Walking Boot, Prefabricated Customized

    HCPCS Level II code L4360 describes a prefabricated walking boot that is pneumatic and/or vacuum-assisted, may include joints and interface material, and has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by a skilled individual; service type is durable medical equipment (DME) fitting and customization, typically provided in outpatient settings such as DME supplier locations, orthopedic clinics, or hospital outpatient departments for ambulatory patients requiring immobilization or protection of the lower extremity.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    Table of contents

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    • Billing CodesCPT, HCPCS, DRG & more
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    Clinical & Coding Specifications

    Clinical Context

    A middle-aged patient presents to an orthopedic clinic after an acute ankle inversion injury sustained while playing recreational sports. The patient has midfoot and hindfoot pain, visible swelling, and tenderness over the lateral malleolus. Radiographs rule out displaced fractures; examination and clinical judgment support a diagnosis of severe ankle sprain with ligamentous instability. The clinician determines that a prefabricated pneumatic or vacuum walking boot with customization (trimming, molding, added interface material) is medically necessary to offload the foot and stabilize the ankle during the subacute recovery phase. The device is fabricated and customized by a certified orthotist or trained clinical professional during the same visit or a scheduled DME fitting appointment.

    Typical clinical workflow:

    • Initial evaluation by the treating clinician (orthopedist, sports medicine physician, or emergency physician) with history and physical exam and ordered radiographs.

    • Decision for a custom-fit prefabricated pneumatic/vacuum walking boot documented in the medical record, including functional limitations and treatment goals.

    • Referral to a durable medical equipment (DME) supplier or on-site orthotics technician for sizing and device customization (trim, bend, mold, add interface) performed by an individual with expertise.

    • Documentation of the customization steps, patient education on wear and care, and follow-up plan for reassessment and potential adjustments.

    Typical site of service: outpatient orthopedic clinic, DME supplier facility, emergency department when applied at initial care, or inpatient setting for post-operative immobilization.

    Typical patient scenario: adult with an acute ankle sprain or midfoot injury requiring semi-rigid immobilization, or a post-operative patient needing offloading and adjustable pneumatic support where a prefabricated boot is trimmed and customized for improved fit and function.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesUsed for the clinician visit during which the walking boot is ordered, medical necessity documented, and follow-up arranged
    99283Emergency department visit for the evaluation and management of an emergency department patient, moderate severityCommonly billed when the boot is applied during an ED visit after acute injury evaluation
    97760Orthotic management and training, initial encounter; lower extremity prosthetic/orthotic device(s), fitting and trainingUsed when initial fitting, adjustments, and patient training are provided by a qualified clinician or orthotist for the boot
    97530Therapeutic activities, direct one-on-one patient contactMay be used in rehabilitation visits following immobilization when functional training continues while using the boot

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    78CPT 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…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    261Q00000XClinic/CenterA facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limite…
    173000000XLegal MedicineThe specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical …
    207RH0005XHypertension Specialist PhysicianA Hypertension Specialist is a physician who concentrates on all aspects of the diagnosis and treatment of hypertension.
    3140N1450XPediatric Skilled Nursing FacilityA nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to…
    156FX1201XOptometric Assistant TechnicianAn optometric assistant assists optometrists by performing duties, including but not limited to, customer service, basic eye testing, and patient educ…
    163WP0218XPediatric Oncology Registered NurseNursing Service Providers · Registered Nurse

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    M25.471Effusion, right ankle
    M25.472Effusion, left ankle
    M25.571Pain in right ankle and joints of right foot
    M25.572Pain in left ankle and joints of left foot
    M77.32Calcaneal spur, left foot
    M77.41Metatarsalgia, right foot
    M79.671Pain in right foot
    M79.672Pain in left foot
    M84.671APathological fracture in other disease, right ankle, initial encounter for fracture
    S82.101AUnspecified fracture of upper end of right tibia, initial encounter for closed fracture

    Showing 1–10 of 24

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    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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    99070Supplies and materials (e.g., bandages, gloves), used during a procedure, not included in the serviceMay be used for non-DME supplies supplied during fitting or customization (billing payer policies vary)