MyMedi-AI

L6200 — Elbow disarticulation, molded socket, outside locking hinge, forearm

HCPCS Level II L-code · short descriptor: “Elbow mold outsid lock hinge”

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.

L6200 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1993.43 to $4961.48 depending on state and rural status.

Former-CBA payment limits: ceiling $4453.13 · floor $3339.85

StateNon-ruralRural
AK$4639.88
AL$3339.85
AR$3900.09
AZ$4453.13
CA$4453.13
CO$3733.04
CT$4069.24
DC$3339.85
DE$3339.85
FL$3339.85
GA$3339.85
HI$4961.48
IA$3998.85
ID$4336.64
IL$4027.88
IN$4027.88
KS$3998.85
KY$3339.85
LA$3900.09
MA$4069.24
MD$3339.85
ME$4069.24
MI$4027.88
MN$4027.88
MO$3998.85
MS$3339.85
MT$3733.04
NC$3339.85
ND$3733.04
NE$3998.85
NH$4069.24
NJ$3339.85
NM$3900.09
NV$4453.13
NY$3339.85
OH$4027.88
OK$3900.09
OR$4336.64
PA$3339.85
PR$1993.43
RI$4069.24
SC$3339.85
SD$3733.04
TN$3339.85
TX$3900.09
UT$3733.04
VA$3339.85
VI$3339.85
VT$4069.24
WA$4336.64
WI$4027.88
WV$3339.85
WY$3733.04
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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