L6055 HCPCS code: Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad
L6055 is the HCPCS Level II code for wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad. The 2026 Medicare DMEPOS fee schedule pays $3,241.30 to $4,370.24 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 5 of 6 L60 codes (family range $1,844.24–$5,456.06).
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 | 1988-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L6055
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $3,241.30 | $4,370.24 | $4,321.73 | $3,241.30 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $4,086.99 | — |
| AL | — | $3,241.30 | — |
| AR | — | $3,475.20 | — |
| AZ | — | $3,964.06 | — |
| CA | — | $3,964.06 | — |
| CO | — | $3,464.91 | — |
| CT | — | $4,067.32 | — |
| DC | — | $3,696.64 | — |
| DE | — | $3,696.64 | — |
| FL | — | $3,241.30 | — |
| GA | — | $3,241.30 | — |
| HI | — | $4,370.24 | — |
| IA | — | $3,412.30 | — |
| ID | — | $3,968.74 | — |
| IL | — | $3,904.27 | — |
| IN | — | $3,904.27 | — |
| KS | — | $3,412.30 | — |
| KY | — | $3,241.30 | — |
| LA | — | $3,475.20 | — |
| MA | — | $4,067.32 | — |
| MD | — | $3,696.64 | — |
| ME | — | $4,067.32 | — |
| MI | — | $3,904.27 | — |
| MN | — | $3,904.27 | — |
| MO | — | $3,412.30 | — |
| MS | — | $3,241.30 | — |
| MT | — | $3,464.91 | — |
| NC | — | $3,241.30 | — |
| ND | — | $3,464.91 | — |
| NE | — | $3,412.30 | — |
| NH | — | $4,067.32 | — |
| NJ | — | $3,535.68 | — |
| NM | — | $3,475.20 | — |
| NV | — | $3,964.06 | — |
| NY | — | $3,535.68 | — |
| OH | — | $3,904.27 | — |
| OK | — | $3,475.20 | — |
| OR | — | $3,968.74 | — |
| PA | — | $3,696.64 | — |
| PR | — | $3,483.50 | — |
| RI | — | $4,067.32 | — |
| SC | — | $3,241.30 | — |
| SD | — | $3,464.91 | — |
| TN | — | $3,241.30 | — |
| TX | — | $3,475.20 | — |
| UT | — | $3,464.91 | — |
| VA | — | $3,696.64 | — |
| VI | — | $3,535.68 | — |
| VT | — | $4,067.32 | — |
| WA | — | $3,968.74 | — |
| WI | — | $3,904.27 | — |
| WV | — | $3,696.64 | — |
| WY | — | $3,464.91 | — |
How the L6055 fee compares
| Measure | Value |
|---|---|
| Rank among 6 L60 codes (lowest = 1) | 5 |
| Family fee range (average of state fees) | $1,844.24–$5,456.06 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Anatomic Consideration |
| outpatient hospital claims | 2 | Anatomic Consideration |
What changed for L6055
- 2026-01-01: Average state fee rose 2.0%: $3,590.47 to $3,662.28
- 1988-01-01: L6055 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 L6055?
L6055 is the HCPCS Level II code for wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad. Short descriptor: "Wrst mold sock w/exp interfa".
How much does Medicare pay for L6055?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $3,241.30–$4,370.24. Rural fees can be higher.
Does Medicare cover L6055?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6055 change in 2026?
The average non-rural state fee moved from $3,590.47 in 2025 to $3,662.28 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6055 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
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, 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
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Next steps
- Run a reimbursement report for a device billed under L6055
- Watch L6055 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6055
Sources: CMS HCPCS Level II release October 2026; 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.