MyMedi-AI

L6713 — Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric

HCPCS Level II L-code · short descriptor: “Ped term dev, hand, vol open”

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.

L6713 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1877.68 to $2065.44 depending on state and rural status.

Former-CBA payment limits: ceiling $2291.39 · floor $1718.55

StateNon-ruralRural
AK$1877.68—
AL$1934.13—
AR$1933.98—
AZ$1877.68—
CA$1877.68—
CO$1944.87—
CT$1877.68—
DC$1877.68—
DE$1877.68—
FL$1934.13—
GA$1934.13—
HI$1877.68—
IA$1914.27—
ID$1877.68—
IL$1923.74—
IN$1923.74—
KS$1914.27—
KY$1934.13—
LA$1933.98—
MA$1877.68—
MD$1877.68—
ME$1877.68—
MI$1923.74—
MN$1923.74—
MO$1914.27—
MS$1934.13—
MT$1944.87—
NC$1934.13—
ND$1944.87—
NE$1914.27—
NH$1877.68—
NJ$1877.68—
NM$1933.98—
NV$1877.68—
NY$1877.68—
OH$1923.74—
OK$1933.98—
OR$1877.68—
PA$1877.68—
PR$2065.44—
RI$1877.68—
SC$1934.13—
SD$1944.87—
TN$1934.13—
TX$1933.98—
UT$1944.87—
VA$1877.68—
VI$2065.44—
VT$1877.68—
WA$1877.68—
WI$1923.74—
WV$1877.68—
WY$1944.87—
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 L6713 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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