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L6615 — Upper extremity addition, disconnect locking wrist unit

HCPCS Level II L-code · short descriptor: “Disconnect locking wrist uni”

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.

L6615 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $122.80 to $263.80 depending on state and rural status.

Former-CBA payment limits: ceiling $283.56 · floor $212.67

StateNon-ruralRural
AK$219.97
AL$234.61
AR$237.69
AZ$224.28
CA$224.28
CO$239.02
CT$212.67
DC$251.34
DE$251.34
FL$234.61
GA$234.61
HI$235.25
IA$233.43
ID$261.64
IL$263.80
IN$263.80
KS$233.43
KY$234.61
LA$237.69
MA$212.67
MD$251.34
ME$212.67
MI$263.80
MN$263.80
MO$233.43
MS$234.61
MT$239.02
NC$234.61
ND$239.02
NE$233.43
NH$212.67
NJ$224.99
NM$237.69
NV$224.28
NY$224.99
OH$263.80
OK$237.69
OR$261.64
PA$251.34
PR$122.80
RI$212.67
SC$234.61
SD$239.02
TN$234.61
TX$237.69
UT$239.02
VA$251.34
VI$224.99
VT$212.67
WA$261.64
WI$263.80
WV$251.34
WY$239.02
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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