MyMedi-AI

L3935 — Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment

HCPCS Level II L-code · short descriptor: “Fo nontorsion joint 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
3
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 2026-10-26; 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 2026-10-26; 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.

L3935 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $241.15 to $265.27 depending on state and rural status.

Former-CBA payment limits: ceiling $294.32 · floor $220.74

StateNon-ruralRural
AK$241.15—
AL$248.47—
AR$248.46—
AZ$241.15—
CA$241.15—
CO$249.87—
CT$241.15—
DC$241.15—
DE$241.15—
FL$248.47—
GA$248.47—
HI$241.15—
IA$245.89—
ID$241.15—
IL$247.07—
IN$247.07—
KS$245.89—
KY$248.47—
LA$248.46—
MA$241.15—
MD$241.15—
ME$241.15—
MI$247.07—
MN$247.07—
MO$245.89—
MS$248.47—
MT$249.87—
NC$248.47—
ND$249.87—
NE$245.89—
NH$241.15—
NJ$241.15—
NM$248.46—
NV$241.15—
NY$241.15—
OH$247.07—
OK$248.46—
OR$241.15—
PA$241.15—
PR$265.27—
RI$241.15—
SC$248.47—
SD$249.87—
TN$248.47—
TX$248.46—
UT$249.87—
VA$241.15—
VI$265.27—
VT$241.15—
WA$241.15—
WI$247.07—
WV$241.15—
WY$249.87—
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 L3935 at 3 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Clinical: Data.

Common denial codes to watch

Related L-codes

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