MyMedi-AI

L7406 — Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)

HCPCS Level II L-code · short descriptor: “Add upp ext mec limb vol lam”

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.

L7406 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable: $3150.07 in all listed states.

StateNon-ruralRural
AK$3150.07
AL$3150.07
AR$3150.07
AZ$3150.07
CA$3150.07
CO$3150.07
CT$3150.07
DC$3150.07
DE$3150.07
FL$3150.07
GA$3150.07
HI$3150.07
IA$3150.07
ID$3150.07
IL$3150.07
IN$3150.07
KS$3150.07
KY$3150.07
LA$3150.07
MA$3150.07
MD$3150.07
ME$3150.07
MI$3150.07
MN$3150.07
MO$3150.07
MS$3150.07
MT$3150.07
NC$3150.07
ND$3150.07
NE$3150.07
NH$3150.07
NJ$3150.07
NM$3150.07
NV$3150.07
NY$3150.07
OH$3150.07
OK$3150.07
OR$3150.07
PA$3150.07
PR$3150.07
RI$3150.07
SC$3150.07
SD$3150.07
TN$3150.07
TX$3150.07
UT$3150.07
VA$3150.07
VI$3150.07
VT$3150.07
WA$3150.07
WI$3150.07
WV$3150.07
WY$3150.07
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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