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L6030 — Upper extremity addition, external frame, partial hand including fingers

HCPCS Level II L-code · short descriptor: “External frame part handfing”

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.

L6030 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $706.16 to $1522.87 depending on state and rural status.

StateNon-ruralRural
AK$728.78
AL$706.16
AR$706.16
AZ$714.22
CA$714.22
CO$941.55
CT$706.16
DC$706.16
DE$706.16
FL$706.16
GA$706.16
HI$779.30
IA$706.16
ID$706.16
IL$706.16
IN$706.16
KS$706.16
KY$706.16
LA$706.16
MA$706.16
MD$706.16
ME$706.16
MI$706.16
MN$706.16
MO$706.16
MS$706.16
MT$941.55
NC$706.16
ND$941.55
NE$706.16
NH$706.16
NJ$718.66
NM$706.16
NV$714.22
NY$718.66
OH$706.16
OK$706.16
OR$706.16
PA$706.16
PR$1522.87
RI$706.16
SC$706.16
SD$941.55
TN$706.16
TX$706.16
UT$941.55
VA$706.16
VI$718.63
VT$706.16
WA$706.16
WI$706.16
WV$706.16
WY$941.55
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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