L3901 HCPCS code: Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated

L3901 is the HCPCS Level II code for wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated. The 2026 Medicare DMEPOS fee schedule pays $1,227.04 to $2,394.77 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on DME suppliers. Its average fee ranks 32 of 38 L39 codes (family range $38.92–$3,752.58).

Code details

FieldValue
SectionL codes — Orthotic and prosthetic procedures and devices
Coverage codeC — Carrier judgment
Pricing indicator38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services
BETOS categoryD1F — Prosthetic and orthotic devices
Added1984-01-01
Last action effective2001-01-01

2026 Medicare DMEPOS fee schedule for L3901

ModifierMeaningLowest state feeHighest state feeCeilingFloor
—base fee$1,227.04$2,394.77$2,409.40$1,807.05
StateModifierFeeRural fee
AK—$2,239.52—
AL—$1,969.72—
AR—$1,807.05—
AZ—$2,192.72—
CA—$2,192.72—
CO—$2,315.28—
CT—$1,807.05—
DC—$1,807.62—
DE—$1,807.62—
FL—$1,969.72—
GA—$1,969.72—
HI—$2,394.77—
IA—$2,109.22—
ID—$2,024.56—
IL—$2,374.53—
IN—$2,374.53—
KS—$2,109.22—
KY—$1,969.72—
LA—$1,807.05—
MA—$1,807.05—
MD—$1,807.62—
ME—$1,807.05—
MI—$2,374.53—
MN—$2,374.53—
MO—$2,109.22—
MS—$1,969.72—
MT—$2,315.28—
NC—$1,969.72—
ND—$2,315.28—
NE—$2,109.22—
NH—$1,807.05—
NJ—$1,999.21—
NM—$1,807.05—
NV—$2,192.72—
NY—$1,999.21—
OH—$2,374.53—
OK—$1,807.05—
OR—$2,024.56—
PA—$1,807.62—
PR—$1,227.04—
RI—$1,807.05—
SC—$1,969.72—
SD—$2,315.28—
TN—$1,969.72—
TX—$1,807.05—
UT—$2,315.28—
VA—$1,807.62—
VI—$1,999.21—
VT—$1,807.05—
WA—$2,024.56—
WI—$2,374.53—
WV—$1,807.62—
WY—$2,315.28—

How the L3901 fee compares

MeasureValue
Rank among 38 L39 codes (lowest = 1)32
Family fee range (average of state fees)$38.92–$3,752.58
Rural fee uplift—

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
DME suppliers2Anatomic Consideration
outpatient hospital claims2Anatomic Consideration

What changed for L3901

Frequently asked questions

What is HCPCS code L3901?

L3901 is the HCPCS Level II code for wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated. Short descriptor: "Hinge ext/flex wrist finger".

How much does Medicare pay for L3901?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,227.04–$2,394.77. Rural fees can be higher.

Does Medicare cover L3901?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Did the Medicare fee for L3901 change in 2026?

The average non-rural state fee moved from $1,989.78 in 2025 to $2,029.58 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of L3901 can be billed per day?

2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).

Related L39 codes

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Next steps

Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; 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.

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