MyMedi-AI

L3702 — Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment

HCPCS Level II L-code · short descriptor: “Eo w/o joints cf”

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
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). 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 (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

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

L3702 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $315.21 to $346.74 depending on state and rural status.

Former-CBA payment limits: ceiling $384.69 · floor $288.51

StateNon-ruralRural
AK$315.21—
AL$324.72—
AR$324.71—
AZ$315.21—
CA$315.21—
CO$326.50—
CT$315.21—
DC$315.21—
DE$315.21—
FL$324.72—
GA$324.72—
HI$315.21—
IA$321.42—
ID$315.21—
IL$322.97—
IN$322.97—
KS$321.42—
KY$324.72—
LA$324.71—
MA$315.21—
MD$315.21—
ME$315.21—
MI$322.97—
MN$322.97—
MO$321.42—
MS$324.72—
MT$326.50—
NC$324.72—
ND$326.50—
NE$321.42—
NH$315.21—
NJ$315.21—
NM$324.71—
NV$315.21—
NY$315.21—
OH$322.97—
OK$324.71—
OR$315.21—
PA$315.21—
PR$346.74—
RI$315.21—
SC$324.72—
SD$326.50—
TN$324.72—
TX$324.71—
UT$326.50—
VA$315.21—
VI$346.74—
VT$315.21—
WA$315.21—
WI$322.97—
WV$315.21—
WY$326.50—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L3702 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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