MyMedi-AI

L6386 — Immediate post surgical or early fitting, each additional cast change and realignment

HCPCS Level II L-code · short descriptor: “Postop ea cast chg & realign”

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.

L6386 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $491.64 to $1427.66 depending on state and rural status.

Former-CBA payment limits: ceiling $655.52 · floor $491.64

StateNon-ruralRural
AK$660.38
AL$491.64
AR$547.30
AZ$655.52
CA$655.52
CO$491.64
CT$553.70
DC$560.51
DE$560.51
FL$491.64
GA$491.64
HI$706.16
IA$558.94
ID$565.14
IL$575.71
IN$575.71
KS$558.94
KY$491.64
LA$547.30
MA$553.70
MD$560.51
ME$553.70
MI$575.71
MN$575.71
MO$558.94
MS$491.64
MT$491.64
NC$491.64
ND$491.64
NE$558.94
NH$553.70
NJ$655.52
NM$547.30
NV$655.52
NY$655.52
OH$575.71
OK$547.30
OR$565.14
PA$560.51
PR$1427.66
RI$553.70
SC$491.64
SD$491.64
TN$491.64
TX$547.30
UT$491.64
VA$560.51
VI$655.52
VT$553.70
WA$565.14
WI$575.71
WV$560.51
WY$491.64
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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