L6621 — Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device
HCPCS Level II L-code · short descriptor: “Flex/ext wrist w/wo friction”
- 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
- 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.
L6621 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $2748.98 to $3023.86 depending on state and rural status.
Former-CBA payment limits: ceiling $3354.73 · floor $2516.05
| State | Non-rural | Rural |
|---|---|---|
| AK | $2748.98 | — |
| AL | $2831.71 | — |
| AR | $2831.48 | — |
| AZ | $2748.98 | — |
| CA | $2748.98 | — |
| CO | $2847.38 | — |
| CT | $2748.98 | — |
| DC | $2748.98 | — |
| DE | $2748.98 | — |
| FL | $2831.71 | — |
| GA | $2831.71 | — |
| HI | $2748.98 | — |
| IA | $2802.69 | — |
| ID | $2748.98 | — |
| IL | $2816.50 | — |
| IN | $2816.50 | — |
| KS | $2802.69 | — |
| KY | $2831.71 | — |
| LA | $2831.48 | — |
| MA | $2748.98 | — |
| MD | $2748.98 | — |
| ME | $2748.98 | — |
| MI | $2816.50 | — |
| MN | $2816.50 | — |
| MO | $2802.69 | — |
| MS | $2831.71 | — |
| MT | $2847.38 | — |
| NC | $2831.71 | — |
| ND | $2847.38 | — |
| NE | $2802.69 | — |
| NH | $2748.98 | — |
| NJ | $2748.98 | — |
| NM | $2831.48 | — |
| NV | $2748.98 | — |
| NY | $2748.98 | — |
| OH | $2816.50 | — |
| OK | $2831.48 | — |
| OR | $2748.98 | — |
| PA | $2748.98 | — |
| PR | $3023.86 | — |
| RI | $2748.98 | — |
| SC | $2831.71 | — |
| SD | $2847.38 | — |
| TN | $2831.71 | — |
| TX | $2831.48 | — |
| UT | $2847.38 | — |
| VA | $2748.98 | — |
| VI | $3023.86 | — |
| VT | $2748.98 | — |
| WA | $2748.98 | — |
| WI | $2816.50 | — |
| WV | $2748.98 | — |
| WY | $2847.38 | — |
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 L6621 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 checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →