MyMedi-AI

L6611 — Addition to upper extremity prosthesis, external powered, additional switch, any type

HCPCS Level II L-code · short descriptor: “Additional switch, ext power”

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 2026-10-25; 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 2026-10-25; 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.

L6611 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $494.85 to $544.35 depending on state and rural status.

Former-CBA payment limits: ceiling $603.87 · floor $452.90

StateNon-ruralRural
AK$494.85—
AL$509.70—
AR$509.68—
AZ$494.85—
CA$494.85—
CO$512.54—
CT$494.85—
DC$494.85—
DE$494.85—
FL$509.70—
GA$509.70—
HI$494.85—
IA$504.49—
ID$494.85—
IL$506.97—
IN$506.97—
KS$504.49—
KY$509.70—
LA$509.68—
MA$494.85—
MD$494.85—
ME$494.85—
MI$506.97—
MN$506.97—
MO$504.49—
MS$509.70—
MT$512.54—
NC$509.70—
ND$512.54—
NE$504.49—
NH$494.85—
NJ$494.85—
NM$509.68—
NV$494.85—
NY$494.85—
OH$506.97—
OK$509.68—
OR$494.85—
PA$494.85—
PR$544.35—
RI$494.85—
SC$509.70—
SD$512.54—
TN$509.70—
TX$509.68—
UT$512.54—
VA$494.85—
VI$544.35—
VT$494.85—
WA$494.85—
WI$506.97—
WV$494.85—
WY$512.54—
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 L6611 at 2 units per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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