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L6637 — Upper extremity addition, nudge control elbow lock

HCPCS Level II L-code · short descriptor: “Nudge control elbow lock”

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.

L6637 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $104.71 to $599.38 depending on state and rural status.

Former-CBA payment limits: ceiling $599.38 · floor $449.54

StateNon-ruralRural
AK$530.98
AL$459.92
AR$527.81
AZ$524.97
CA$524.97
CO$449.54
CT$599.38
DC$507.30
DE$507.30
FL$459.92
GA$459.92
HI$567.81
IA$476.68
ID$531.94
IL$497.80
IN$497.80
KS$476.68
KY$459.92
LA$527.81
MA$599.38
MD$507.30
ME$599.38
MI$497.80
MN$497.80
MO$476.68
MS$459.92
MT$449.54
NC$459.92
ND$449.54
NE$476.68
NH$599.38
NJ$449.54
NM$527.81
NV$524.97
NY$449.54
OH$497.80
OK$527.81
OR$531.94
PA$507.30
PR$104.71
RI$599.38
SC$459.92
SD$449.54
TN$459.92
TX$527.81
UT$449.54
VA$507.30
VI$449.54
VT$599.38
WA$531.94
WI$497.80
WV$507.30
WY$449.54
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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