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L3670 — Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf

HCPCS Level II L-code · short descriptor: “So acro/clav can web pre ots”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Prosthetics & orthotics
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (April 13, 2026 update — 83 items). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L3670 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $127.15 to $215.52 depending on state and rural status.

Former-CBA payment limits: ceiling $169.54 · floor $127.15

StateNon-ruralRural
AK$201.55
AL$161.08
AR$132.02
AZ$169.54
CA$169.54
CO$127.15
CT$127.15
DC$152.73
DE$152.73
FL$161.08
GA$161.08
HI$215.52
IA$169.54
ID$132.18
IL$127.15
IN$127.15
KS$169.54
KY$161.08
LA$132.02
MA$127.15
MD$152.73
ME$127.15
MI$127.15
MN$127.15
MO$169.54
MS$161.08
MT$127.15
NC$161.08
ND$127.15
NE$169.54
NH$127.15
NJ$150.78
NM$132.02
NV$169.54
NY$150.78
OH$127.15
OK$132.02
OR$132.18
PA$152.73
PR$142.76
RI$127.15
SC$161.08
SD$127.15
TN$161.08
TX$132.02
UT$127.15
VA$152.73
VI$150.78
VT$127.15
WA$132.18
WI$127.15
WV$152.73
WY$127.15
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related L-codes

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