# HCPCS L4631: Ankle-foot orthosis, walking boot type, with or without joints

Medicare HCPCS L4631 pays $1,926.48 on average under the 2026 Q4 Medicare DMEPOS Fee Schedule (non-rural). State amounts run from $1,710.05 in Wyoming to $3,027.97 in Puerto Rico, a 77% spread.

Web page: https://www.med-reveal.com/rates/L4631-hcpcs-fee-schedule
Section: DME, Prosthetics, Orthotics and Supplies

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $1,926.48 |
| National facility | $1,926.48 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Puerto Rico | $3,027.97 | $3,027.97 |
| Hawaii | $2,542.49 | $2,542.49 |
| Alaska | $2,412.72 | $2,412.72 |
| Arizona | $2,257.57 | $2,257.57 |
| California | $2,257.57 | $2,257.57 |
| Nevada | $2,257.57 | $2,257.57 |
| Virgin Islands | $2,181.33 | $2,181.33 |
| New Jersey | $2,160.48 | $2,160.48 |
| New York | $2,160.48 | $2,160.48 |
| Connecticut | $1,967.57 | $1,967.57 |
| Maine | $1,967.57 | $1,967.57 |
| Massachusetts | $1,967.57 | $1,967.57 |
| New Hampshire | $1,967.57 | $1,967.57 |
| Rhode Island | $1,967.57 | $1,967.57 |
| Vermont | $1,967.57 | $1,967.57 |
| Delaware | $1,912.64 | $1,912.64 |
| District of Columbia | $1,912.64 | $1,912.64 |
| Maryland | $1,912.64 | $1,912.64 |
| Pennsylvania | $1,912.64 | $1,912.64 |
| Virginia | $1,912.64 | $1,912.64 |
| West Virginia | $1,912.64 | $1,912.64 |
| Alabama | $1,843.94 | $1,843.94 |
| Florida | $1,843.94 | $1,843.94 |
| Georgia | $1,843.94 | $1,843.94 |
| Kentucky | $1,843.94 | $1,843.94 |
| Mississippi | $1,843.94 | $1,843.94 |
| North Carolina | $1,843.94 | $1,843.94 |
| South Carolina | $1,843.94 | $1,843.94 |
| Tennessee | $1,843.94 | $1,843.94 |
| Idaho | $1,834.95 | $1,834.95 |
| Oregon | $1,834.95 | $1,834.95 |
| Washington | $1,834.95 | $1,834.95 |
| Arkansas | $1,827.50 | $1,827.50 |
| Louisiana | $1,827.50 | $1,827.50 |
| New Mexico | $1,827.50 | $1,827.50 |
| Oklahoma | $1,827.50 | $1,827.50 |
| Texas | $1,827.50 | $1,827.50 |
| Illinois | $1,811.67 | $1,811.67 |
| Indiana | $1,811.67 | $1,811.67 |
| Michigan | $1,811.67 | $1,811.67 |
| Minnesota | $1,811.67 | $1,811.67 |
| Ohio | $1,811.67 | $1,811.67 |
| Wisconsin | $1,811.67 | $1,811.67 |
| Iowa | $1,760.00 | $1,760.00 |
| Kansas | $1,760.00 | $1,760.00 |
| Missouri | $1,760.00 | $1,760.00 |
| Nebraska | $1,760.00 | $1,760.00 |
| Colorado | $1,710.05 | $1,710.05 |
| Montana | $1,710.05 | $1,710.05 |
| North Dakota | $1,710.05 | $1,710.05 |
| South Dakota | $1,710.05 | $1,710.05 |
| Utah | $1,710.05 | $1,710.05 |
| Wyoming | $1,710.05 | $1,710.05 |

## Related codes

- L0112: Cranial cervical orthosis, congenital torticollis type — https://www.med-reveal.com/rates/L0112-hcpcs-fee-schedule
- L0140: Cervical, semi-rigid, thermoplastic collar, molded to patient — https://www.med-reveal.com/rates/L0140-hcpcs-fee-schedule
- L0450: Thoracic-lumbar-sacral orthosis (TLSO), flexible, provides trunk support — https://www.med-reveal.com/rates/L0450-hcpcs-fee-schedule
- L0500: Thoracic-lumbar-sacral orthosis (TLSO), rigid, custom fitted — https://www.med-reveal.com/rates/L0500-hcpcs-fee-schedule
- L0621: Sacroiliac orthosis, flexible, provides pelvic-sacral support — https://www.med-reveal.com/rates/L0621-hcpcs-fee-schedule
- L0630: Lumbar-sacral orthosis, sagittal control, rigid posterior panel — https://www.med-reveal.com/rates/L0630-hcpcs-fee-schedule
- L0810: Addition to halo procedure, cervical collar with attachment — https://www.med-reveal.com/rates/L0810-hcpcs-fee-schedule
- L1000: Cervical-thoracic-lumbar-sacral orthosis, anterior-posterior-lateral control — https://www.med-reveal.com/rates/L1000-hcpcs-fee-schedule

Commercial negotiated rates for L4631 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules