MyMedi-AI

L6350 — Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm

HCPCS Level II L-code · short descriptor: “Thoracic intern 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.

L6350 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $3169.88 to $6936.42 depending on state and rural status.

Former-CBA payment limits: ceiling $6393.71 · floor $4795.29

StateNon-ruralRural
AK$6486.81
AL$4795.29
AR$4795.29
AZ$6345.51
CA$6345.51
CO$5599.78
CT$4795.29
DC$4795.29
DE$4795.29
FL$4795.29
GA$4795.29
HI$6936.42
IA$5773.80
ID$6393.71
IL$5988.72
IN$5988.72
KS$5773.80
KY$4795.29
LA$4795.29
MA$4795.29
MD$4795.29
ME$4795.29
MI$5988.72
MN$5988.72
MO$5773.80
MS$4795.29
MT$5599.78
NC$4795.29
ND$5599.78
NE$5773.80
NH$4795.29
NJ$6393.71
NM$4795.29
NV$6345.51
NY$6393.71
OH$5988.72
OK$4795.29
OR$6393.71
PA$4795.29
PR$3169.88
RI$4795.29
SC$4795.29
SD$5599.78
TN$4795.29
TX$4795.29
UT$5599.78
VA$4795.29
VI$6393.71
VT$4795.29
WA$6393.71
WI$5988.72
WV$4795.29
WY$5599.78
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

Bill L6350 with confidence

MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, L6350 included, and starter credits via POST /bot-marketplace/register.