# HCPCS L5301: Below knee prosthesis, molded socket, shin, SACH foot, endoskeletal system

Medicare HCPCS L5301 pays $3,222.48 on average under the 2026 Q4 Medicare DMEPOS Fee Schedule (non-rural). State amounts run from $2,810.90 in West Virginia to $4,330.82 in Puerto Rico, a 54% spread.

Web page: https://www.med-reveal.com/rates/L5301-hcpcs-fee-schedule
Section: DME, Prosthetics, Orthotics and Supplies

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $3,222.48 |
| National facility | $3,222.48 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Puerto Rico | $4,330.82 | $4,330.82 |
| Hawaii | $4,314.60 | $4,314.60 |
| Alaska | $3,983.69 | $3,983.69 |
| Arizona | $3,731.84 | $3,731.84 |
| California | $3,731.84 | $3,731.84 |
| Nevada | $3,731.84 | $3,731.84 |
| Idaho | $3,429.81 | $3,429.81 |
| Oregon | $3,429.81 | $3,429.81 |
| Washington | $3,429.81 | $3,429.81 |
| Arkansas | $3,376.36 | $3,376.36 |
| Louisiana | $3,376.36 | $3,376.36 |
| New Mexico | $3,376.36 | $3,376.36 |
| Oklahoma | $3,376.36 | $3,376.36 |
| Texas | $3,376.36 | $3,376.36 |
| Alabama | $3,367.55 | $3,367.55 |
| Florida | $3,367.55 | $3,367.55 |
| Georgia | $3,367.55 | $3,367.55 |
| Kentucky | $3,367.55 | $3,367.55 |
| Mississippi | $3,367.55 | $3,367.55 |
| North Carolina | $3,367.55 | $3,367.55 |
| South Carolina | $3,367.55 | $3,367.55 |
| Tennessee | $3,367.55 | $3,367.55 |
| Illinois | $3,299.01 | $3,299.01 |
| Indiana | $3,299.01 | $3,299.01 |
| Michigan | $3,299.01 | $3,299.01 |
| Minnesota | $3,299.01 | $3,299.01 |
| Ohio | $3,299.01 | $3,299.01 |
| Wisconsin | $3,299.01 | $3,299.01 |
| Iowa | $3,185.00 | $3,185.00 |
| Kansas | $3,185.00 | $3,185.00 |
| Missouri | $3,185.00 | $3,185.00 |
| Nebraska | $3,185.00 | $3,185.00 |
| Connecticut | $3,003.12 | $3,003.12 |
| Maine | $3,003.12 | $3,003.12 |
| Massachusetts | $3,003.12 | $3,003.12 |
| New Hampshire | $3,003.12 | $3,003.12 |
| Rhode Island | $3,003.12 | $3,003.12 |
| Vermont | $3,003.12 | $3,003.12 |
| Colorado | $2,834.07 | $2,834.07 |
| Montana | $2,834.07 | $2,834.07 |
| North Dakota | $2,834.07 | $2,834.07 |
| South Dakota | $2,834.07 | $2,834.07 |
| Utah | $2,834.07 | $2,834.07 |
| Wyoming | $2,834.07 | $2,834.07 |
| Delaware | $2,810.90 | $2,810.90 |
| District of Columbia | $2,810.90 | $2,810.90 |
| Maryland | $2,810.90 | $2,810.90 |
| New Jersey | $2,810.90 | $2,810.90 |
| New York | $2,810.90 | $2,810.90 |
| Pennsylvania | $2,810.90 | $2,810.90 |
| Virgin Islands | $2,810.90 | $2,810.90 |
| Virginia | $2,810.90 | $2,810.90 |
| West Virginia | $2,810.90 | $2,810.90 |

## Related codes

- L5000: Partial foot prosthesis, shoe insert with longitudinal arch, toe filler — https://www.med-reveal.com/rates/L5000-hcpcs-fee-schedule
- L5010: Partial foot prosthesis, molded socket, ankle height, soft interface — https://www.med-reveal.com/rates/L5010-hcpcs-fee-schedule
- L5050: Ankle symes prosthesis, molded socket — https://www.med-reveal.com/rates/L5050-hcpcs-fee-schedule
- L5100: Below knee prosthesis, molded socket, shin, SACH foot — https://www.med-reveal.com/rates/L5100-hcpcs-fee-schedule
- L5200: Above knee prosthesis, molded socket, single axis constant friction knee — https://www.med-reveal.com/rates/L5200-hcpcs-fee-schedule
- L5321: Above knee prosthesis, molded socket, open end, endoskeletal system — https://www.med-reveal.com/rates/L5321-hcpcs-fee-schedule
- L5400: Immediate post-surgical or early fitting, application of initial rigid dressing — https://www.med-reveal.com/rates/L5400-hcpcs-fee-schedule
- L5500: Initial, below knee PTB type socket, non-alignable system — https://www.med-reveal.com/rates/L5500-hcpcs-fee-schedule

Commercial negotiated rates for L5301 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