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L6695 Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism
BackL6026Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)→L6028Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692→L6029Upper extremity addition, test socket/interface, partial hand including fingers→L6030Upper extremity addition, external frame, partial hand including fingers→L6031Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power→L6032Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)→L6033Addition to upper extremity prosthesis, partial hand including fingers, acrylic material→L6034Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692→L6035Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement→L6036Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement→L6037Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers→L6038Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material→L6039Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb→L6050Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad→L6055Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad→L6100Below elbow, molded socket, flexible elbow hinge, triceps pad→L6110Below elbow, molded socket, (muenster or northwestern suspension types)→L6120Below elbow, molded double wall split socket, step-up hinges, half cuff→L6130Below elbow, molded double wall split socket, stump activated locking hinge, half cuff→L6200Elbow disarticulation, molded socket, outside locking hinge, forearm→L6205Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm→L6250Above elbow, molded double wall socket, internal locking elbow, forearm→L6300Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm→L6310Shoulder disarticulation, passive restoration (complete prosthesis)→L6320Shoulder disarticulation, passive restoration (shoulder cap only)→L6350Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm→L6360Interscapular thoracic, passive restoration (complete prosthesis)→L6370Interscapular thoracic, passive restoration (shoulder cap only)→L6380Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow→L6382Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow→L6384Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic→L6386Immediate post surgical or early fitting, each additional cast change and realignment→L6388Immediate post surgical or early fitting, application of rigid dressing only→L6400Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping→L6450Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping→L6500Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping→L6550Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping→L6570Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping→L6580Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model→L6582Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed→L6584Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model→L6586Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed→L6588Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model→L6590Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed→L6600Upper extremity additions, polycentric hinge, pair→L6605Upper extremity additions, single pivot hinge, pair→L6610Upper extremity additions, flexible metal hinge, pair→L6611Addition to upper extremity prosthesis, external powered, additional switch, any type→L6615Upper extremity addition, disconnect locking wrist unit→L6616Upper extremity addition, additional disconnect insert for locking wrist unit, each→L6620Upper extremity addition, flexion/extension wrist unit, with or without friction→L6621Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device→L6623Upper extremity addition, spring assisted rotational wrist unit with latch release→L6624Upper extremity addition, flexion/extension and rotation wrist unit→L6625Upper extremity addition, rotation wrist unit with cable lock→L6628Upper extremity addition, quick disconnect hook adapter, otto bock or equal→L6629Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal→L6630Upper extremity addition, stainless steel, any wrist→L6632Upper extremity addition, latex suspension sleeve, each→L6635Upper extremity addition, lift assist for elbow→L6637Upper extremity addition, nudge control elbow lock→L6638Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow→L6640Upper extremity additions, shoulder abduction joint, pair→L6641Upper extremity addition, excursion amplifier, pulley type→L6642Upper extremity addition, excursion amplifier, lever type→L6645Upper extremity addition, shoulder flexion-abduction joint, each→L6646Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system→L6647Upper extremity addition, shoulder lock mechanism, body powered actuator→L6648Upper extremity addition, shoulder lock mechanism, external powered actuator→L6650Upper extremity addition, shoulder universal joint, each→L6655Upper extremity addition, standard control cable, extra→L6660Upper extremity addition, heavy duty control cable→L6665Upper extremity addition, teflon, or equal, cable lining→L6670Upper extremity addition, hook to hand, cable adapter→L6672Upper extremity addition, harness, chest or shoulder, saddle type→L6675Upper extremity addition, harness, (e.g., figure of eight type), single cable design→L6676Upper extremity addition, harness, (e.g., figure of eight type), dual cable design→L6677Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow→L6680Upper extremity addition, test socket, wrist disarticulation or below elbow→L6682Upper extremity addition, test socket, elbow disarticulation or above elbow→L6684Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic→L6686Upper extremity addition, suction socket→L6687Upper extremity addition, frame type socket, below elbow or wrist disarticulation→L6688Upper extremity addition, frame type socket, above elbow or elbow disarticulation→L6689Upper extremity addition, frame type socket, shoulder disarticulation→L6690Upper extremity addition, frame type socket, interscapular-thoracic→L6691Upper extremity addition, removable insert, each→L6692Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each→L6693Upper extremity addition, locking elbow, forearm counterbalance→L6694Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism→L6695Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism→L6696Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)→L6697Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)→L6698Addition to upper extremity prosthesis, lock mechanism, excludes socket insert→L6700Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement→L6703Terminal device, passive hand/mitt, any material, any size→L6704Terminal device, sport/recreational/work attachment, any material, any size→L6706Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined→L6707Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined→L6708Terminal device, hand, mechanical, voluntary opening, any material, any size→L6709Terminal device, hand, mechanical, voluntary closing, any material, any size→L6711Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric→L6712Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric→L6713Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric→L6714Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric→L6715Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement→L6721Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined→L6722Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined→L6805Addition to terminal device, modifier wrist unit→L6810Addition to terminal device, precision pinch device→L6880Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)→L6881Automatic grasp feature, addition to upper limb electric prosthetic terminal device→L6882Microprocessor control feature, addition to upper limb prosthetic terminal device→L6883Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power→L6884Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power→L6885Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power→L6890Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment→L6895Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated→L6900Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining→L6905Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining→L6910Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining→L6915Hand restoration (shading, and measurements included), replacement glove for above→L6920Wrist 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→L6925Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device→L6930Below elbow, 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→L6935Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device→L6940Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device→L6945Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device→L6950Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device→L6955Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device→L6960Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device→L6965Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device→L6970Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device→L6975Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device→
Procedure codeCODABLE
L6695
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism
- Part
- HCPCS Level II
- L
- Orthotic and Prosthetic Procedures and Devices
- L6
- L6026–L6975
Source
CMS — ICD-10-PCS FY2026, HCPCS Level II october 2026, Procedure Codes 2026.