MyMedi-AI

L6610 — Upper extremity additions, flexible metal hinge, pair

HCPCS Level II L-code · short descriptor: “Flexible metal 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
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-26; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). 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 (CMS Required F2F & WOPD List — 83 items in force on 2026-10-26; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L6610 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $122.80 to $355.20 depending on state and rural status.

Former-CBA payment limits: ceiling $271.77 · floor $203.83

StateNon-ruralRural
AK$332.16—
AL$217.74—
AR$247.59—
AZ$271.77—
CA$271.77—
CO$207.51—
CT$203.83—
DC$203.83—
DE$203.83—
FL$217.74—
GA$217.74—
HI$355.20—
IA$226.50—
ID$214.09—
IL$271.77—
IN$271.77—
KS$226.50—
KY$217.74—
LA$247.59—
MA$203.83—
MD$203.83—
ME$203.83—
MI$271.77—
MN$271.77—
MO$226.50—
MS$217.74—
MT$207.51—
NC$217.74—
ND$207.51—
NE$226.50—
NH$203.83—
NJ$203.83—
NM$247.59—
NV$271.77—
NY$203.83—
OH$271.77—
OK$247.59—
OR$214.09—
PA$203.83—
PR$122.80—
RI$203.83—
SC$217.74—
SD$207.51—
TN$217.74—
TX$247.59—
UT$207.51—
VA$203.83—
VI$203.83—
VT$203.83—
WA$214.09—
WI$271.77—
WV$203.83—
WY$207.51—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L6610 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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