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L6884 — Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power

HCPCS Level II L-code · short descriptor: “Replc sockt above elbow disa”

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
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.

L6884 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1429.03 to $4669.01 depending on state and rural status.

Former-CBA payment limits: ceiling $3644.20 · floor $2733.15

StateNon-ruralRural
AK$4326.49
AL$2883.44
AR$3428.45
AZ$3644.20
CA$3644.20
CO$2733.15
CT$2756.73
DC$2733.15
DE$2733.15
FL$2883.44
GA$2883.44
HI$4669.01
IA$3257.71
ID$3428.23
IL$3346.77
IN$3346.77
KS$3257.71
KY$2883.44
LA$3428.45
MA$2756.73
MD$2733.15
ME$2756.73
MI$3346.77
MN$3346.77
MO$3257.71
MS$2883.44
MT$2733.15
NC$2883.44
ND$2733.15
NE$3257.71
NH$2756.73
NJ$2848.58
NM$3428.45
NV$3644.20
NY$2848.58
OH$3346.77
OK$3428.45
OR$3428.23
PA$2733.15
PR$1429.03
RI$2756.73
SC$2883.44
SD$2733.15
TN$2883.44
TX$3428.45
UT$2733.15
VA$2733.15
VI$2733.15
VT$2756.73
WA$3428.23
WI$3346.77
WV$2733.15
WY$2733.15
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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