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L6805 — Addition to terminal device, modifier wrist unit

HCPCS Level II L-code · short descriptor: “Term dev modifier wrist unit”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Special coverage instructions apply
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.

L6805 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $296.48 to $554.72 depending on state and rural status.

Former-CBA payment limits: ceiling $555.38 · floor $416.53

StateNon-ruralRural
AK$518.80
AL$416.53
AR$520.97
AZ$518.39
CA$518.39
CO$435.97
CT$442.69
DC$440.68
DE$440.68
FL$416.53
GA$416.53
HI$554.72
IA$532.91
ID$517.80
IL$472.26
IN$472.26
KS$532.91
KY$416.53
LA$520.97
MA$442.69
MD$440.68
ME$442.69
MI$472.26
MN$472.26
MO$532.91
MS$416.53
MT$435.97
NC$416.53
ND$435.97
NE$532.91
NH$442.69
NJ$488.94
NM$520.97
NV$518.39
NY$488.94
OH$472.26
OK$520.97
OR$517.80
PA$440.68
PR$296.48
RI$442.69
SC$416.53
SD$435.97
TN$416.53
TX$520.97
UT$435.97
VA$440.68
VI$488.93
VT$442.69
WA$517.80
WI$472.26
WV$440.68
WY$435.97
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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