MyMedi-AI

L6648 — Upper extremity addition, shoulder lock mechanism, external powered actuator

HCPCS Level II L-code · short descriptor: “Ext pwrd shlder lock/unlock”

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
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). 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 (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L6648 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $3909.46 to $4300.39 depending on state and rural status.

Former-CBA payment limits: ceiling $4770.93 · floor $3578.20

StateNon-ruralRural
AK$3909.46—
AL$4027.16—
AR$4026.82—
AZ$3909.46—
CA$3909.46—
CO$4049.41—
CT$3909.46—
DC$3909.46—
DE$3909.46—
FL$4027.16—
GA$4027.16—
HI$3909.46—
IA$3985.77—
ID$3909.46—
IL$4005.49—
IN$4005.49—
KS$3985.77—
KY$4027.16—
LA$4026.82—
MA$3909.46—
MD$3909.46—
ME$3909.46—
MI$4005.49—
MN$4005.49—
MO$3985.77—
MS$4027.16—
MT$4049.41—
NC$4027.16—
ND$4049.41—
NE$3985.77—
NH$3909.46—
NJ$3909.46—
NM$4026.82—
NV$3909.46—
NY$3909.46—
OH$4005.49—
OK$4026.82—
OR$3909.46—
PA$3909.46—
PR$4300.39—
RI$3909.46—
SC$4027.16—
SD$4049.41—
TN$4027.16—
TX$4026.82—
UT$4049.41—
VA$3909.46—
VI$4300.39—
VT$3909.46—
WA$3909.46—
WI$4005.49—
WV$3909.46—
WY$4049.41—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L6648 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.

Common denial codes to watch

Related L-codes

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