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L7186 — Electronic elbow, child, variety village or equal, switch controlled

HCPCS Level II L-code · short descriptor: “Electron elbow child switch”

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.

L7186 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $10430.01 to $14162.40 depending on state and rural status.

Former-CBA payment limits: ceiling $14438.86 · floor $10829.14

StateNon-ruralRural
AK$10430.01
AL$10829.14
AR$13988.06
AZ$10829.14
CA$10829.14
CO$14162.40
CT$11914.40
DC$11223.26
DE$11223.26
FL$10829.14
GA$10829.14
HI$11152.86
IA$13336.16
ID$10829.14
IL$13091.11
IN$13091.11
KS$13336.16
KY$10829.14
LA$13988.06
MA$11914.40
MD$11223.26
ME$11914.40
MI$13091.11
MN$13091.11
MO$13336.16
MS$10829.14
MT$14162.40
NC$10829.14
ND$14162.40
NE$13336.16
NH$11914.40
NJ$13374.00
NM$13988.06
NV$10829.14
NY$13374.00
OH$13091.11
OK$13988.06
OR$10829.14
PA$11223.26
PR$13373.92
RI$11914.40
SC$10829.14
SD$14162.40
TN$10829.14
TX$13988.06
UT$14162.40
VA$11223.26
VI$13374.00
VT$11914.40
WA$10829.14
WI$13091.11
WV$11223.26
WY$14162.40
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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