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L6635 — Upper extremity addition, lift assist for elbow

HCPCS Level II L-code · short descriptor: “Lift assist for elbow”

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.

L6635 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $153.44 to $328.22 depending on state and rural status.

Former-CBA payment limits: ceiling $287.51 · floor $215.63

StateNon-ruralRural
AK$306.94
AL$215.63
AR$270.85
AZ$287.51
CA$287.51
CO$253.60
CT$220.62
DC$244.39
DE$244.39
FL$215.63
GA$215.63
HI$328.22
IA$242.22
ID$231.34
IL$254.26
IN$254.26
KS$242.22
KY$215.63
LA$270.85
MA$220.62
MD$244.39
ME$220.62
MI$254.26
MN$254.26
MO$242.22
MS$215.63
MT$253.60
NC$215.63
ND$253.60
NE$242.22
NH$220.62
NJ$247.39
NM$270.85
NV$287.51
NY$247.39
OH$254.26
OK$270.85
OR$231.34
PA$244.39
PR$153.44
RI$220.62
SC$215.63
SD$253.60
TN$215.63
TX$270.85
UT$253.60
VA$244.39
VI$247.40
VT$220.62
WA$231.34
WI$254.26
WV$244.39
WY$253.60
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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