HCPCS Code L5657

Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials

Orthotic and Prosthetic Procedures, Devices

L5657 is a valid 2026 HCPCS code for Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials or just “Add low ext man aut vol any” for short, used in Lump sum purchase of DME, prosthetics, orthotics.

HCPCS Code Details - L5657

HCPCS Level II Code
Orthotic and Prosthetic Procedures, Devices
HCPCS Code L5657
Description

Long description:
Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials

Short description:
Add low ext man aut vol any

HCPCS Modifier1
HCPCS Pricing indicator 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code D1F - Prosthetic/Orthotic devices
HCPCS Action code P - Payment change (MOG, pricing indicator codes, anesthesia base units,Ambulatory Surgical Centers)
Type of service P - Lump sum purchase of DME, prosthetics, orthotics
Effective date Effective Apr 01, 2026
Date added Added Oct 01, 2025
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
“NU” identifies the hospital bed as new equipment

See also

  • HCPCS L5656 · Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)

  • HCPCS K0672 · Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each

  • HCPCS K1022 · Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type

  • HCPCS L2180 · Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints

  • HCPCS L2182 · Addition to lower extremity fracture orthosis, drop lock knee joint

  • HCPCS L2184 · Addition to lower extremity fracture orthosis, limited motion knee joint

  • HCPCS L2186 · Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type

  • HCPCS L2188 · Addition to lower extremity fracture orthosis, quadrilateral brim

  • HCPCS L2190 · Addition to lower extremity fracture orthosis, waist belt

  • HCPCS L2192 · Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt

  • HCPCS L2200 · Addition to lower extremity, limited ankle motion, each joint

  • HCPCS L2210 · Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint

  • HCPCS L2220 · Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint

  • HCPCS L2221 · Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source

  • HCPCS L2230 · Addition to lower extremity, split flat caliper stirrups and plate attachment

  • HCPCS L2232 · Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only

  • HCPCS L5658 · Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”