L3999 HCPCS code: Upper limb orthosis, not otherwise specified
L3999 is the HCPCS Level II code for upper limb orthosis, not otherwise specified. In 2024 Medicare paid an average of $304.31 per service for L3999 across 3,332 services. 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 outpatient hospital claims. Medicare volume rose 45% from 2022 to 2024 (2,304 to 3,332 services). In 2024, 132 suppliers billed Medicare for L3999 (purchases), serving 3,249 beneficiaries; Texas, Kentucky, California accounted for 30% of services.
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 46 — Priced by the Medicare contractor (no national fee) |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1982-01-01 |
| Last action effective | 1998-01-01 |
Who bills L3999 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 132 |
| Referring clinicians | 1,828 |
| Medicare beneficiaries | 3,249 |
| States with claims | 37 |
| Share of services in top 3 states (Texas, Kentucky, California) | 30% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 115 | 2,257 |
| 2023 | 103 | 2,194 |
| 2024 | 132 | 3,249 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L3999, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,304 | 2,257 | $295.02 | $232.24 |
| 2023 | 2,247 | 2,194 | $319.39 | $249.90 |
| 2024 | 3,332 | 3,249 | $389.58 | $304.31 |
States with the most L3999 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 519 | $327.24 |
| Kentucky | 227 | $355.51 |
| California | 219 | $321.53 |
| Florida | 210 | $292.49 |
| Missouri | 129 | $195.73 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: Data |
What changed for L3999
- 1982-01-01: L3999 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 L3999?
L3999 is the HCPCS Level II code for upper limb orthosis, not otherwise specified. Short descriptor: "Upper limb orthosis nos".
How much does Medicare pay for L3999?
In 2024, the average Medicare payment was $304.31 per service (average allowed $389.58).
Does Medicare cover L3999?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of L3999 can be billed per day?
2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L39 codes
- L3900 — Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated ($920.35–$1,941.24)
- L3901 — Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated ($1,227.04–$2,394.77)
- L3904 — Wrist hand finger orthosis, external powered, electric, custom fabricated ($2,345.68–$6,383.35)
- L3905 — Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment ($1,082.62–$1,190.84)
- L3906 — Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ($380.72–$650.39)
- L3908 — Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf ($49.93–$125.86)
- L3912 — Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf ($65.50–$172.42)
- L3913 — Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment ($295.66–$325.21)
- L3915 — Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, 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 ($580.28–$638.37)
- L3916 — Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf ($580.28–$638.37)
- L3917 — Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ($115.37–$126.80)
- L3918 — Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf ($115.37–$126.80)
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 L3999
- Watch L3999 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L3999
Sources: CMS HCPCS Level II release October 2026; 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.