L3677 HCPCS code: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L3677 is the HCPCS Level II code for shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise. In 2023 Medicare paid an average of $55.63 per service for L3677 across 16 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on DME suppliers. Medicare volume fell 68% from 2022 to 2023 (50 to 16 services). In 2023, 6 suppliers billed Medicare for L3677 (purchases), serving 16 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2002-01-01 |
| Last action effective | 2014-01-01 |
Who bills L3677 (2023)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 6 |
| Referring clinicians | 9 |
| Medicare beneficiaries | 16 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 6 | 49 |
| 2023 | 6 | 16 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L3677, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 50 | 49 | $62.20 | $47.43 |
| 2023 | 16 | 16 | $90.88 | $55.63 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
What changed for L3677
- 2002-01-01: L3677 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L3677?
L3677 is the HCPCS Level II code for shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise. Short descriptor: "So hard plas stabili pre cst".
How much does Medicare pay for L3677?
In 2023, the average Medicare payment was $55.63 per service (average allowed $90.88).
Does Medicare cover L3677?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of L3677 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related L36 codes
- L3600 — Transfer of an orthosis from one shoe to another, caliper plate, existing ($91.55–$100.71)
- L3610 — Transfer of an orthosis from one shoe to another, caliper plate, new ($120.51–$132.57)
- L3620 — Transfer of an orthosis from one shoe to another, solid stirrup, existing ($91.55–$100.71)
- L3630 — Transfer of an orthosis from one shoe to another, solid stirrup, new ($120.51–$132.57)
- L3640 — Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes ($51.86–$57.05)
- L3649 — Orthopedic shoe, modification, addition or transfer, not otherwise specified
- L3650 — Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf ($66.69–$105.67)
- L3660 — Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf ($112.56–$154.10)
- L3670 — Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf ($127.15–$215.52)
- L3671 — Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ($983.68–$1,082.00)
- L3674 — Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment ($1,290.37–$1,419.42)
- L3675 — Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf ($191.58–$229.91)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under L3677
- Watch L3677 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L3677
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.