MyMedi-AI

L6920 — Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device

HCPCS Level II L-code · short descriptor: “Wrist disarticul switch ctrl”

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.

L6920 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $8170.29 to $10469.46 depending on state and rural status.

Former-CBA payment limits: ceiling $10893.72 · floor $8170.29

StateNon-ruralRural
AK$9230.82
AL$8170.29
AR$8971.39
AZ$9127.55
CA$9127.55
CO$9931.59
CT$9337.30
DC$9436.79
DE$9436.79
FL$8170.29
GA$8170.29
HI$9870.54
IA$9192.07
ID$9526.30
IL$10315.01
IN$10315.01
KS$9192.07
KY$8170.29
LA$8971.39
MA$9337.30
MD$9436.79
ME$9337.30
MI$10315.01
MN$10315.01
MO$9192.07
MS$8170.29
MT$9931.59
NC$8170.29
ND$9931.59
NE$9192.07
NH$9337.30
NJ$8170.29
NM$8971.39
NV$9127.55
NY$8170.29
OH$10315.01
OK$8971.39
OR$9526.30
PA$9436.79
PR$10469.46
RI$9337.30
SC$8170.29
SD$9931.59
TN$8170.29
TX$8971.39
UT$9931.59
VA$9436.79
VI$8170.29
VT$9337.30
WA$9526.30
WI$10315.01
WV$9436.79
WY$9931.59
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

Bill L6920 with confidence

MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.

Start free trial   Run a CMS-0057-F readiness check

Prefer DIY compliance? Self-audit documentation kits for DME suppliers →

Building an AI agent? Try the agent API in the playground — free PA-required lookups, L6920 included, and starter credits via POST /bot-marketplace/register.