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L6686 — Upper extremity addition, suction socket

HCPCS Level II L-code · short descriptor: “Suction socket”

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.

L6686 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $722.75 to $1361.04 depending on state and rural status.

Former-CBA payment limits: ceiling $963.67 · floor $722.75

StateNon-ruralRural
AK$1002.04
AL$963.67
AR$793.42
AZ$963.67
CA$963.67
CO$722.75
CT$963.67
DC$793.56
DE$793.56
FL$963.67
GA$963.67
HI$1071.44
IA$722.75
ID$813.95
IL$844.29
IN$844.29
KS$722.75
KY$963.67
LA$793.42
MA$963.67
MD$793.56
ME$963.67
MI$844.29
MN$844.29
MO$722.75
MS$963.67
MT$722.75
NC$963.67
ND$722.75
NE$722.75
NH$963.67
NJ$733.33
NM$793.42
NV$963.67
NY$733.33
OH$844.29
OK$793.42
OR$813.95
PA$793.56
PR$1361.04
RI$963.67
SC$963.67
SD$722.75
TN$963.67
TX$793.42
UT$722.75
VA$793.56
VI$733.34
VT$963.67
WA$813.95
WI$844.29
WV$793.56
WY$722.75
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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