L6384 — Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic
HCPCS Level II L-code · short descriptor: “Postop dsg cast chg shlder/t”
- 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
- 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.
L6384 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $2334.16 to $3997.43 depending on state and rural status.
Former-CBA payment limits: ceiling $3112.22 · floor $2334.16
| State | Non-rural | Rural |
|---|---|---|
| AK | $2720.03 | — |
| AL | $3112.22 | — |
| AR | $2363.50 | — |
| AZ | $2583.31 | — |
| CA | $2583.31 | — |
| CO | $2686.88 | — |
| CT | $2334.16 | — |
| DC | $2337.34 | — |
| DE | $2337.34 | — |
| FL | $3112.22 | — |
| GA | $3112.22 | — |
| HI | $2908.55 | — |
| IA | $2334.16 | — |
| ID | $2495.07 | — |
| IL | $2626.33 | — |
| IN | $2626.33 | — |
| KS | $2334.16 | — |
| KY | $3112.22 | — |
| LA | $2363.50 | — |
| MA | $2334.16 | — |
| MD | $2337.34 | — |
| ME | $2334.16 | — |
| MI | $2626.33 | — |
| MN | $2626.33 | — |
| MO | $2334.16 | — |
| MS | $3112.22 | — |
| MT | $2686.88 | — |
| NC | $3112.22 | — |
| ND | $2686.88 | — |
| NE | $2334.16 | — |
| NH | $2334.16 | — |
| NJ | $3112.22 | — |
| NM | $2363.50 | — |
| NV | $2583.31 | — |
| NY | $3112.22 | — |
| OH | $2626.33 | — |
| OK | $2363.50 | — |
| OR | $2495.07 | — |
| PA | $2337.34 | — |
| PR | $3997.43 | — |
| RI | $2334.16 | — |
| SC | $3112.22 | — |
| SD | $2686.88 | — |
| TN | $3112.22 | — |
| TX | $2363.50 | — |
| UT | $2686.88 | — |
| VA | $2337.34 | — |
| VI | $3112.22 | — |
| VT | $2334.16 | — |
| WA | $2495.07 | — |
| WI | $2626.33 | — |
| WV | $2337.34 | — |
| WY | $2686.88 | — |
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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