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L6630 — Upper extremity addition, stainless steel, any wrist

HCPCS Level II L-code · short descriptor: “Stainless steel any wrist”

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.

L6630 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $24.55 to $351.80 depending on state and rural status.

Former-CBA payment limits: ceiling $351.80 · floor $263.85

StateNon-ruralRural
AK$240.23
AL$263.85
AR$351.80
AZ$263.85
CA$263.85
CO$263.85
CT$351.80
DC$263.85
DE$263.85
FL$263.85
GA$263.85
HI$256.89
IA$263.85
ID$263.85
IL$351.80
IN$351.80
KS$263.85
KY$263.85
LA$351.80
MA$351.80
MD$263.85
ME$351.80
MI$351.80
MN$351.80
MO$263.85
MS$263.85
MT$263.85
NC$263.85
ND$263.85
NE$263.85
NH$351.80
NJ$263.85
NM$351.80
NV$263.85
NY$263.85
OH$351.80
OK$351.80
OR$263.85
PA$263.85
PR$24.55
RI$351.80
SC$263.85
SD$263.85
TN$263.85
TX$351.80
UT$263.85
VA$263.85
VI$263.85
VT$351.80
WA$263.85
WI$351.80
WV$263.85
WY$263.85
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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