MyMedi-AI

L6721 — Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined

HCPCS Level II L-code · short descriptor: “Hook/hand, hvy dty, 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.

L6721 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $2826.66 to $3109.40 depending on state and rural status.

Former-CBA payment limits: ceiling $3449.56 · floor $2587.17

StateNon-ruralRural
AK$2826.66—
AL$2911.82—
AR$2911.54—
AZ$2826.66—
CA$2826.66—
CO$2927.87—
CT$2826.66—
DC$2826.66—
DE$2826.66—
FL$2911.82—
GA$2911.82—
HI$2826.66—
IA$2881.90—
ID$2826.66—
IL$2896.15—
IN$2896.15—
KS$2881.90—
KY$2911.82—
LA$2911.54—
MA$2826.66—
MD$2826.66—
ME$2826.66—
MI$2896.15—
MN$2896.15—
MO$2881.90—
MS$2911.82—
MT$2927.87—
NC$2911.82—
ND$2927.87—
NE$2881.90—
NH$2826.66—
NJ$2826.66—
NM$2911.54—
NV$2826.66—
NY$2826.66—
OH$2896.15—
OK$2911.54—
OR$2826.66—
PA$2826.66—
PR$3109.40—
RI$2826.66—
SC$2911.82—
SD$2927.87—
TN$2911.82—
TX$2911.54—
UT$2927.87—
VA$2826.66—
VI$3109.40—
VT$2826.66—
WA$2826.66—
WI$2896.15—
WV$2826.66—
WY$2927.87—
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 L6721 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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