L5707 – Custom shaped protective cover, hip disarticulation
HCPCS Level II code · L codes: Orthotic and Prosthetic Procedures and Devices
HCPCS codeL5707
- Long description
- Custom shaped protective cover, hip disarticulation
- Short description
- Custom shape cvr hip disart
- Pricing indicator
38Orthotics, prosthetics, prosthetic devices & vision services- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 1994
- Last change
- January 1, 2002 – No change
Frequently asked questions
What is HCPCS code L5707?
L5707 is a HCPCS Level II code for custom shaped protective cover, hip disarticulation.
Does Medicare cover L5707?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby L codes
- L5699 – All lower extremity prostheses, shoulder harness
- L5700 – Replacement, socket, below knee, molded to patient model
- L5701 – Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model
- L5702 – Replacement, socket, hip disarticulation, including hip joint, molded to patient model
- L5703 – Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only
- L5704 – Custom shaped protective cover, below knee
- L5705 – Custom shaped protective cover, above knee
- L5706 – Custom shaped protective cover, knee disarticulation
- L5710 – Addition, exoskeletal knee-shin system, single axis, manual lock
- L5711 – Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material
- L5712 – Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
- L5714 – Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control
- L5716 – Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock
- L5718 – Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control
- L5722 – Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control
- L5724 – Addition, exoskeletal knee-shin system, single axis, fluid swing phase control
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.