L6036 HCPCS code: 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
L6036 is the HCPCS Level II code for 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. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2025-10-01 |
| Last action effective | 2025-10-01 |
What changed for L6036
- October 2025: Code appears in this HCPCS release
- 2025-10-01: L6036 added to HCPCS Level II
- 2025-10-01: Last CMS action: code added
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L6036?
L6036 is the HCPCS Level II code for 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. Short descriptor: "Prosthetic thumb mechanical".
Does Medicare cover L6036?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related L60 codes
- L6000 — Partial hand, thumb remaining ($1,145.38–$2,941.25)
- L6010 — Partial hand, little and/or ring finger remaining ($1,145.38–$3,328.97)
- L6020 — Partial hand, no finger remaining ($1,186.07–$3,048.37)
- L6025 — 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
- 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) ($4,589.94–$6,119.92)
- 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, including palm, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692
- L6029 — Upper extremity addition, test socket/interface, partial hand including fingers
- L6030 — Upper extremity addition, external frame, partial hand including fingers
- L6031 — Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power
- L6032 — Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)
- L6033 — Addition to upper extremity prosthesis, partial hand including fingers, acrylic material
- 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
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 L6036
- Watch L6036 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6036
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.