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L6300 — Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm

HCPCS Level II L-code · short descriptor: “Shlder disart int lock elbow”

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.

L6300 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $2658.47 to $6899.63 depending on state and rural status.

Former-CBA payment limits: ceiling $6081.45 · floor $4561.09

StateNon-ruralRural
AK$6452.40
AL$4561.09
AR$4870.31
AZ$6081.45
CA$6081.45
CO$4873.61
CT$6077.74
DC$4561.09
DE$4561.09
FL$4561.09
GA$4561.09
HI$6899.63
IA$5135.89
ID$5688.70
IL$5465.70
IN$5465.70
KS$5135.89
KY$4561.09
LA$4870.31
MA$6077.74
MD$4561.09
ME$6077.74
MI$5465.70
MN$5465.70
MO$5135.89
MS$4561.09
MT$4873.61
NC$4561.09
ND$4873.61
NE$5135.89
NH$6077.74
NJ$5536.03
NM$4870.31
NV$6081.45
NY$5536.03
OH$5465.70
OK$4870.31
OR$5688.70
PA$4561.09
PR$2658.47
RI$6077.74
SC$4561.09
SD$4873.61
TN$4561.09
TX$4870.31
UT$4873.61
VA$4561.09
VI$5536.03
VT$6077.74
WA$5688.70
WI$5465.70
WV$4561.09
WY$4873.61
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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