L3925 — Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Fo pip dip jnt/sprng 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
- 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.
L3925 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $45.08 to $75.84 depending on state and rural status.
Former-CBA payment limits: ceiling $74.01 · floor $55.50
| State | Non-rural | Rural |
|---|---|---|
| AK | $70.98 | — |
| AL | $59.39 | — |
| AR | $60.42 | — |
| AZ | $71.73 | — |
| CA | $71.73 | — |
| CO | $55.50 | — |
| CT | $58.68 | — |
| DC | $56.51 | — |
| DE | $56.51 | — |
| FL | $59.39 | — |
| GA | $59.39 | — |
| HI | $75.84 | — |
| IA | $71.46 | — |
| ID | $69.78 | — |
| IL | $73.47 | — |
| IN | $73.47 | — |
| KS | $71.46 | — |
| KY | $59.39 | — |
| LA | $60.42 | — |
| MA | $58.68 | — |
| MD | $56.51 | — |
| ME | $58.68 | — |
| MI | $73.47 | — |
| MN | $73.47 | — |
| MO | $71.46 | — |
| MS | $59.39 | — |
| MT | $55.50 | — |
| NC | $59.39 | — |
| ND | $55.50 | — |
| NE | $71.46 | — |
| NH | $58.68 | — |
| NJ | $55.50 | — |
| NM | $60.42 | — |
| NV | $71.73 | — |
| NY | $55.50 | — |
| OH | $73.47 | — |
| OK | $60.42 | — |
| OR | $69.78 | — |
| PA | $56.51 | — |
| PR | $45.08 | — |
| RI | $58.68 | — |
| SC | $59.39 | — |
| SD | $55.50 | — |
| TN | $59.39 | — |
| TX | $60.42 | — |
| UT | $55.50 | — |
| VA | $56.51 | — |
| VI | $55.50 | — |
| VT | $58.68 | — |
| WA | $69.78 | — |
| WI | $73.47 | — |
| WV | $56.51 | — |
| WY | $55.50 | — |
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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