Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.31
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l5926-lower-extremity-prosthesis-rotational-unit
    Ask Trek AI about this page

    HCPCS L5926: Lower Extremity Prosthesis Positional Rotation Unit

    HCPCS Level II code L5926 describes an addition to a lower extremity prosthesis for endoskeletal systems at the knee disarticulation, above-knee, or hip disarticulation levels, specifying a positional rotation unit used to allow rotational positioning of the prosthetic limb; service type is a prosthetic component addition typically provided in prosthetics/orthotics clinics or specialty DME supplier settings during prosthesis fitting and adjustment.

    For related coverage guidance, see recent payer policy updates: Speech Therapy for Autism Disorders - Medical Policy, Physical Performance Test or Measurement, Sensory Integration Therapy and Auditory Integration Training.

    Customize your policy alerts

    Sign up for hcpcs L5926 policy alerts

    Get alerted when payer policies referencing L5926 are released or updated.

    Monitor payer policy activity

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

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old male with a traumatic transfemoral amputation and subsequent residual limb rotation issues presents for prosthetic component adjustment. The patient uses an endoskeletal lower extremity prosthesis fitted for knee disarticulation/above-knee level and occasionally requires a positional rotation unit to improve alignment, socket comfort, and gait dynamics. The prosthetist evaluates gait in the prosthetics clinic, documents rotational malalignment or functional need for an adjustable rotational unit, selects an appropriate positional rotation unit compatible with the existing endoskeletal pylon and knee assembly, and orders the addition under billing code L5926. The workflow includes clinical assessment, measurement and selection of the device, fabrication/assembly in the prosthetic lab, fitting appointment with alignment tuning, and a follow-up visit to document functional improvement and address complications such as loosening or skin irritation. Typical site of service is an outpatient prosthetics clinic or orthotics and prosthetics (O&P) facility with device fabrication capability. Typical patient considerations include activity level, residual limb shape, socket fit, and existing knee or hip components; documentation must support medical necessity and functional benefit for the rotation unit.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic(s) management and training, initial encounterUsed for prosthetic training and initial functional education after adding a rotation unit
    97763Orthotic/prosthetic supply; training, follow-up adjustmentsApplied for subsequent training sessions and adjustment visits related to the positional rotation unit
    97750Physical performance test or measurementUsed for objective gait or functional testing to document need or outcome after the rotation unit addition
    97001Physical therapy evaluationPerformed when a physical therapist evaluates gait and function to support prosthetic changes
    99070Supplies and materials (non-physician)Billed for expendable materials or minor supplies used during fitting or fabrication
    L4360Knee joint, axis of rotation components (example related HCPCS)Represents other prosthetic knee components that may be evaluated or replaced in the same episode of care

    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…
    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…
    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…
    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…
    P1Modifier P1 indicates an ASA Physical Status I — a normal healthy patient — and is appended to anesthesia CPT codes (00100–01999) based on the anesthesiologist’s clinical assessment. It documents the…- When to apply: Use modifier P1 on anesthesia CPT codes (00100–01999) when the anesthesia provider assigns ASA Physical Status I — a normal healthy patient (non‑smoker, minimal or no alcohol use).…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208200000X
    207RC0000X
    225100000X
    333600000X
    208C00000X
    2084P0301X
    251K00000X
    341600000X

    Related ICD-10-CM Codes

    18 rows

    ICD-10-CM CodeDescription
    G54.5Neuralgic amyotrophy
    G54.6Phantom limb syndrome with pain
    M75.81Other shoulder lesions, right shoulder
    M75.82Other shoulder lesions, left shoulder
    M79.641Pain in right hand
    M79.642Pain in left hand
    M96.841Postprocedural hematoma of a musculoskeletal structure following other procedure
    M96.842Postprocedural seroma of a musculoskeletal structure following a musculoskeletal system procedure
    R26.2Difficulty in walking, not elsewhere classified
    R26.89Other abnormalities of gait and mobility

    Showing 1–10 of 18

    Related Payer Policy Updates

    Specialty: Physical Medicine, Rehab & Therapies1 / 2

    10 rows

    PolicyPayerEffective Date
    Speech Therapy for Autism Disorders - Medical PolicyHealth-New-England2026-12-01
    Physical Performance Test or MeasurementCigna2026-11-15
    Sensory Integration Therapy and Auditory Integration TrainingColorado Rocky Mountain Health Plans2026-11-01
    Skilled Nursing and Skilled Rehabilitation Services (Outpatient)Anthem2026-10-01
    Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Mexico Only)UnitedHealthcare2026-10-01
    Physical Therapy/Medicine Corporate Medical Policybcbsvermont2026-10-01
    Cognitive Rehabilitation Corporate Medical Policybcbsvermont2026-10-01
    Speech Language Pathology/Therapy Services Corporate Medical Policybcbsvermont2026-10-01
    Occupational Therapy Corporate Medical Policybcbsvermont2026-10-01
    Biomagnetic TherapyConnectiCare2026-09-11

    Related Codes

    HCPCS-L5000-PARTIAL-FOOT-SHOE-INSERT-LONGITUDINAL-ARCH-TOE-FILLER

    HCPCS Level II L5000: Partial Foot Shoe Insert with Longitudinal Arch, Toe Filler

    HCPCS-L5010-PARTIAL-FOOT-MOLDED-SOCKET-ANKLE-HEIGHT-TOE-FILLER

    HCPCS L5010: Partial Foot Molded Socket, Ankle Height, With Toe Filler

    HCPCS-L5020-PARTIAL-FOOT-MOLDED-SOCKET-TIBIAL-TUBERCLE-TOE-FILLER

    HCPCS L5020: Partial Foot Molded Socket with Toe Filler

    HCPCS-L5050-ANKLE-SYMES-MOLDED-SOCKET-SACH-FOOT

    HCPCS L5050: Ankle/Symes Molded Socket with SACH Foot

    HCPCS-L5060-ANKLE-SYMES-METAL-FRAME-MOLDED-LEATHER-SOCKET-ARTICULATED-ANKLE-FOOT

    HCPCS L5060: Ankle/Symes Metal Frame with Molded Leather Socket

    HCPCS-L5100-BELOW-KNEE-MOLDED-SOCKET-SHIN-SACH-FOOT

    HCPCS Level II L5100: Below-Knee Molded Socket with Shin and SACH Foot

    HCPCS-L5105-BELOW-KNEE-PLASTIC-SOCKET-SACH-FOOT

    HCPCS L5105: Below-Knee Plastic Socket Prosthesis with SACH Foot

    HCPCS-L5150-KNEE-DISARTICULATION-MOLDED-SOCKET-EXTERNAL-KNEE-SACH-FOOT

    HCPCS L5150: Knee Disarticulation Molded Socket with External Knee and SACH Foot

    HCPCS-L5160-KNEE-DISARTICULATION-MOLDED-SOCKET-BENT-KNEE-SACH-FOOT

    HCPCS Level II L5160: Knee Disarticulation Molded Socket, Bent Knee Configuration

    HCPCS-L5200-ABOVE-KNEE-MOLDED-SOCKET-SINGLE-AXIS-KNEE-SACH-FOOT

    HCPCS Level II L5200: Above-knee Prosthesis with Molded Socket and Single-axis Knee

    Showing 1–10 of 472

    • More pages

    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.
    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.