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L6645 — Upper extremity addition, shoulder flexion-abduction joint, each

HCPCS Level II L-code · short descriptor: “Shoulder flexion-abduction j”

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.

L6645 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $347.81 to $595.86 depending on state and rural status.

Former-CBA payment limits: ceiling $521.09 · floor $390.82

StateNon-ruralRural
AK$557.23
AL$491.37
AR$493.10
AZ$521.09
CA$521.09
CO$390.82
CT$390.82
DC$397.82
DE$397.82
FL$491.37
GA$491.37
HI$595.86
IA$414.21
ID$485.36
IL$448.35
IN$448.35
KS$414.21
KY$491.37
LA$493.10
MA$390.82
MD$397.82
ME$390.82
MI$448.35
MN$448.35
MO$414.21
MS$491.37
MT$390.82
NC$491.37
ND$390.82
NE$414.21
NH$390.82
NJ$395.10
NM$493.10
NV$521.09
NY$395.10
OH$448.35
OK$493.10
OR$485.36
PA$397.82
PR$347.81
RI$390.82
SC$491.37
SD$390.82
TN$491.37
TX$493.10
UT$390.82
VA$397.82
VI$395.12
VT$390.82
WA$485.36
WI$448.35
WV$397.82
WY$390.82
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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