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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
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.

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

StateNon-ruralRural
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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