MyMedi-AI

L6130 — Below elbow, molded double wall split socket, stump activated locking hinge, half cuff

HCPCS Level II L-code · short descriptor: “Elbow stump activated lock h”

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.

L6130 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1564.55 to $5581.92 depending on state and rural status.

Former-CBA payment limits: ceiling $4225.63 · floor $3169.22

StateNon-ruralRural
AK$5220.15
AL$3169.22
AR$3205.49
AZ$4225.63
CA$4225.63
CO$3463.03
CT$3554.58
DC$3169.22
DE$3169.22
FL$3169.22
GA$3169.22
HI$5581.92
IA$3630.90
ID$4225.63
IL$3910.12
IN$3910.12
KS$3630.90
KY$3169.22
LA$3205.49
MA$3554.58
MD$3169.22
ME$3554.58
MI$3910.12
MN$3910.12
MO$3630.90
MS$3169.22
MT$3463.03
NC$3169.22
ND$3463.03
NE$3630.90
NH$3554.58
NJ$3917.63
NM$3205.49
NV$4225.63
NY$3917.63
OH$3910.12
OK$3205.49
OR$4225.63
PA$3169.22
PR$1564.55
RI$3554.58
SC$3169.22
SD$3463.03
TN$3169.22
TX$3205.49
UT$3463.03
VA$3169.22
VI$3917.63
VT$3554.58
WA$4225.63
WI$3910.12
WV$3169.22
WY$3463.03
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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