L5781 – Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system
HCPCS Level II code · L codes: Orthotic and Prosthetic Procedures and Devices
HCPCS codeL5781
- Long description
- Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system
- Short description
- Lower limb pros vacuum pump
- 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, 2003
- Last change
- January 1, 2003 – No change
Frequently asked questions
What is HCPCS code L5781?
L5781 is a HCPCS Level II code for addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system.
Does Medicare cover L5781?
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
- 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
- L5726 – Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control
- L5728 – Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control
- L5780 – Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control
- L5782 – Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty
- L5783 – Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)
- L5785 – Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
- L5790 – Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)
- L5795 – Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)
- L5810 – Addition, endoskeletal knee-shin system, single axis, manual lock
- L5811 – Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material
- L5812 – Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.