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L6884
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Procedure Codes
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HCPCS Level II
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Orthotic and Prosthetic Procedures and Devices
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L6026–L6975
L6884
Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
Back
L6026
Transcarpal/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)
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L6028
Partial 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
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L6029
Upper extremity addition, test socket/interface, partial hand including fingers
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L6030
Upper extremity addition, external frame, partial hand including fingers
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L6031
Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power
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L6032
Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)
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L6033
Addition to upper extremity prosthesis, partial hand including fingers, acrylic material
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L6034
Partial 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
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L6035
Single 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
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L6036
Prosthetic 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
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L6037
Immediate 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
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L6038
Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material
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L6039
Passive 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
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L6050
Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad
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L6055
Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad
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L6100
Below elbow, molded socket, flexible elbow hinge, triceps pad
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L6110
Below elbow, molded socket, (muenster or northwestern suspension types)
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L6120
Below elbow, molded double wall split socket, step-up hinges, half cuff
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L6130
Below elbow, molded double wall split socket, stump activated locking hinge, half cuff
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L6200
Elbow disarticulation, molded socket, outside locking hinge, forearm
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L6205
Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm
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L6250
Above elbow, molded double wall socket, internal locking elbow, forearm
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L6300
Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
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L6310
Shoulder disarticulation, passive restoration (complete prosthesis)
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L6320
Shoulder disarticulation, passive restoration (shoulder cap only)
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L6350
Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
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L6360
Interscapular thoracic, passive restoration (complete prosthesis)
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L6370
Interscapular thoracic, passive restoration (shoulder cap only)
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L6380
Immediate 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
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L6382
Immediate 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
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L6384
Immediate 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
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L6386
Immediate post surgical or early fitting, each additional cast change and realignment
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L6388
Immediate post surgical or early fitting, application of rigid dressing only
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L6400
Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
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L6450
Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
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L6500
Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
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L6550
Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
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L6570
Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping
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L6580
Preparatory, 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
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L6582
Preparatory, 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
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L6584
Preparatory, 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
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L6586
Preparatory, 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
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L6588
Preparatory, 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
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L6590
Preparatory, 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
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L6600
Upper extremity additions, polycentric hinge, pair
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L6605
Upper extremity additions, single pivot hinge, pair
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L6610
Upper extremity additions, flexible metal hinge, pair
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L6611
Addition to upper extremity prosthesis, external powered, additional switch, any type
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L6615
Upper extremity addition, disconnect locking wrist unit
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L6616
Upper extremity addition, additional disconnect insert for locking wrist unit, each
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L6620
Upper extremity addition, flexion/extension wrist unit, with or without friction
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L6621
Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device
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L6623
Upper extremity addition, spring assisted rotational wrist unit with latch release
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L6624
Upper extremity addition, flexion/extension and rotation wrist unit
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L6625
Upper extremity addition, rotation wrist unit with cable lock
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L6628
Upper extremity addition, quick disconnect hook adapter, otto bock or equal
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L6629
Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal
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L6630
Upper extremity addition, stainless steel, any wrist
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L6632
Upper extremity addition, latex suspension sleeve, each
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L6635
Upper extremity addition, lift assist for elbow
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L6637
Upper extremity addition, nudge control elbow lock
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L6638
Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow
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L6640
Upper extremity additions, shoulder abduction joint, pair
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L6641
Upper extremity addition, excursion amplifier, pulley type
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L6642
Upper extremity addition, excursion amplifier, lever type
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L6645
Upper extremity addition, shoulder flexion-abduction joint, each
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L6646
Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system
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L6647
Upper extremity addition, shoulder lock mechanism, body powered actuator
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L6648
Upper extremity addition, shoulder lock mechanism, external powered actuator
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L6650
Upper extremity addition, shoulder universal joint, each
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L6655
Upper extremity addition, standard control cable, extra
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L6660
Upper extremity addition, heavy duty control cable
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L6665
Upper extremity addition, teflon, or equal, cable lining
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L6670
Upper extremity addition, hook to hand, cable adapter
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L6672
Upper extremity addition, harness, chest or shoulder, saddle type
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L6675
Upper extremity addition, harness, (e.g., figure of eight type), single cable design
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L6676
Upper extremity addition, harness, (e.g., figure of eight type), dual cable design
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L6677
Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow
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L6680
Upper extremity addition, test socket, wrist disarticulation or below elbow
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L6682
Upper extremity addition, test socket, elbow disarticulation or above elbow
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L6684
Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic
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L6686
Upper extremity addition, suction socket
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L6687
Upper extremity addition, frame type socket, below elbow or wrist disarticulation
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L6688
Upper extremity addition, frame type socket, above elbow or elbow disarticulation
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L6689
Upper extremity addition, frame type socket, shoulder disarticulation
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L6690
Upper extremity addition, frame type socket, interscapular-thoracic
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L6691
Upper extremity addition, removable insert, each
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L6692
Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each
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L6693
Upper extremity addition, locking elbow, forearm counterbalance
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L6694
Addition 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
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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
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L6696
Addition 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)
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L6697
Addition 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)
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L6698
Addition to upper extremity prosthesis, lock mechanism, excludes socket insert
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L6700
Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement
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L6703
Terminal device, passive hand/mitt, any material, any size
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L6704
Terminal device, sport/recreational/work attachment, any material, any size
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L6706
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined
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L6707
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined
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L6708
Terminal device, hand, mechanical, voluntary opening, any material, any size
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L6709
Terminal device, hand, mechanical, voluntary closing, any material, any size
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L6711
Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric
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L6712
Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric
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L6713
Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric
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L6714
Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric
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L6715
Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement
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L6721
Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined
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L6722
Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined
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L6805
Addition to terminal device, modifier wrist unit
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L6810
Addition to terminal device, precision pinch device
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L6880
Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)
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L6881
Automatic grasp feature, addition to upper limb electric prosthetic terminal device
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L6882
Microprocessor control feature, addition to upper limb prosthetic terminal device
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L6883
Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power
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L6884
Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
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L6885
Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power
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L6890
Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
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L6895
Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated
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L6900
Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining
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L6905
Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining
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L6910
Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining
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L6915
Hand restoration (shading, and measurements included), replacement glove for above
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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
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L6925
Wrist 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
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L6930
Below 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
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L6935
Below 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
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L6940
Elbow 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
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L6945
Elbow 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
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L6950
Above 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
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L6955
Above 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
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L6960
Shoulder 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
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L6965
Shoulder 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
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L6970
Interscapular-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
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L6975
Interscapular-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
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Procedure code
CODABLE
L6884
Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
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.
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