MyMedi-AI

L6605 — Upper extremity additions, single pivot hinge, pair

HCPCS Level II L-code · short descriptor: “Single pivot hinge pair”

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.

L6605 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $133.09 to $425.09 depending on state and rural status.

Former-CBA payment limits: ceiling $302.33 · floor $226.75

StateNon-ruralRural
AK$397.58
AL$226.75
AR$302.33
AZ$302.33
CA$302.33
CO$226.75
CT$226.75
DC$227.07
DE$227.07
FL$226.75
GA$226.75
HI$425.09
IA$226.75
ID$234.74
IL$287.48
IN$287.48
KS$226.75
KY$226.75
LA$302.33
MA$226.75
MD$227.07
ME$226.75
MI$287.48
MN$287.48
MO$226.75
MS$226.75
MT$226.75
NC$226.75
ND$226.75
NE$226.75
NH$226.75
NJ$302.33
NM$302.33
NV$302.33
NY$302.33
OH$287.48
OK$302.33
OR$234.74
PA$227.07
PR$133.09
RI$226.75
SC$226.75
SD$226.75
TN$226.75
TX$302.33
UT$226.75
VA$227.07
VI$302.33
VT$226.75
WA$234.74
WI$287.48
WV$227.07
WY$226.75
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 L6605 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, L6605 included, and starter credits via POST /bot-marketplace/register.