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L6640 — Upper extremity additions, shoulder abduction joint, pair

HCPCS Level II L-code · short descriptor: “Shoulder abduction joint pai”

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.

L6640 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $153.44 to $457.23 depending on state and rural status.

Former-CBA payment limits: ceiling $457.23 · floor $342.92

StateNon-ruralRural
AK$337.32
AL$408.59
AR$441.57
AZ$342.92
CA$342.92
CO$359.09
CT$342.92
DC$346.19
DE$346.19
FL$408.59
GA$408.59
HI$360.74
IA$351.96
ID$421.76
IL$414.58
IN$414.58
KS$351.96
KY$408.59
LA$441.57
MA$342.92
MD$346.19
ME$342.92
MI$414.58
MN$414.58
MO$351.96
MS$408.59
MT$359.09
NC$408.59
ND$359.09
NE$351.96
NH$342.92
NJ$457.23
NM$441.57
NV$342.92
NY$457.23
OH$414.58
OK$441.57
OR$421.76
PA$346.19
PR$153.44
RI$342.92
SC$408.59
SD$359.09
TN$408.59
TX$441.57
UT$359.09
VA$346.19
VI$457.23
VT$342.92
WA$421.76
WI$414.58
WV$346.19
WY$359.09
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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