L3764 — Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Level II L-code · short descriptor: “Ewho w/joint(s) 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
- 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.
L3764 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $654.99 to $1110.75 depending on state and rural status.
Former-CBA payment limits: ceiling $1107.68 · floor $830.76
| State | Non-rural | Rural |
|---|---|---|
| AK | $1062.60 | — |
| AL | $890.38 | — |
| AR | $855.35 | — |
| AZ | $1058.69 | — |
| CA | $1058.69 | — |
| CO | $868.24 | — |
| CT | $1037.96 | — |
| DC | $1000.17 | — |
| DE | $1000.17 | — |
| FL | $890.38 | — |
| GA | $890.38 | — |
| HI | $1110.75 | — |
| IA | $830.76 | — |
| ID | $906.20 | — |
| IL | $875.94 | — |
| IN | $875.94 | — |
| KS | $830.76 | — |
| KY | $890.38 | — |
| LA | $855.35 | — |
| MA | $1037.96 | — |
| MD | $1000.17 | — |
| ME | $1037.96 | — |
| MI | $875.94 | — |
| MN | $875.94 | — |
| MO | $830.76 | — |
| MS | $890.38 | — |
| MT | $868.24 | — |
| NC | $890.38 | — |
| ND | $868.24 | — |
| NE | $830.76 | — |
| NH | $1037.96 | — |
| NJ | $1058.65 | — |
| NM | $855.35 | — |
| NV | $1058.69 | — |
| NY | $1058.65 | — |
| OH | $875.94 | — |
| OK | $855.35 | — |
| OR | $906.20 | — |
| PA | $1000.17 | — |
| PR | $654.99 | — |
| RI | $1037.96 | — |
| SC | $890.38 | — |
| SD | $868.24 | — |
| TN | $890.38 | — |
| TX | $855.35 | — |
| UT | $868.24 | — |
| VA | $1000.17 | — |
| VI | $1095.47 | — |
| VT | $1037.96 | — |
| WA | $906.20 | — |
| WI | $875.94 | — |
| WV | $1000.17 | — |
| WY | $868.24 | — |
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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