MyMedi-AI

L6055 — Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad

HCPCS Level II L-code · short descriptor: “Wrst mold sock w/exp interfa”

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.

L6055 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $3241.30 to $4370.24 depending on state and rural status.

Former-CBA payment limits: ceiling $4321.73 · floor $3241.30

StateNon-ruralRural
AK$4086.99
AL$3241.30
AR$3475.20
AZ$3964.06
CA$3964.06
CO$3464.91
CT$4067.32
DC$3696.64
DE$3696.64
FL$3241.30
GA$3241.30
HI$4370.24
IA$3412.30
ID$3968.74
IL$3904.27
IN$3904.27
KS$3412.30
KY$3241.30
LA$3475.20
MA$4067.32
MD$3696.64
ME$4067.32
MI$3904.27
MN$3904.27
MO$3412.30
MS$3241.30
MT$3464.91
NC$3241.30
ND$3464.91
NE$3412.30
NH$4067.32
NJ$3535.68
NM$3475.20
NV$3964.06
NY$3535.68
OH$3904.27
OK$3475.20
OR$3968.74
PA$3696.64
PR$3483.50
RI$4067.32
SC$3241.30
SD$3464.91
TN$3241.30
TX$3475.20
UT$3464.91
VA$3696.64
VI$3535.68
VT$4067.32
WA$3968.74
WI$3904.27
WV$3696.64
WY$3464.91
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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