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L6885 — Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power

HCPCS Level II L-code · short descriptor: “Replc sockt shldr dis/interc”

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.

L6885 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $1533.73 to $7462.35 depending on state and rural status.

Former-CBA payment limits: ceiling $5199.26 · floor $3899.44

StateNon-ruralRural
AK$6978.69
AL$4312.59
AR$3899.44
AZ$5199.26
CA$5199.26
CO$3899.44
CT$3899.44
DC$3936.67
DE$3936.67
FL$4312.59
GA$4312.59
HI$7462.35
IA$3933.40
ID$5199.26
IL$5199.26
IN$5199.26
KS$3933.40
KY$4312.59
LA$3899.44
MA$3899.44
MD$3936.67
ME$3899.44
MI$5199.26
MN$5199.26
MO$3933.40
MS$4312.59
MT$3899.44
NC$4312.59
ND$3899.44
NE$3933.40
NH$3899.44
NJ$3899.44
NM$3899.44
NV$5199.26
NY$3899.44
OH$5199.26
OK$3899.44
OR$5199.26
PA$3936.67
PR$1533.73
RI$3899.44
SC$4312.59
SD$3899.44
TN$4312.59
TX$3899.44
UT$3899.44
VA$3936.67
VI$3899.44
VT$3899.44
WA$5199.26
WI$5199.26
WV$3936.67
WY$3899.44
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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