L6130 HCPCS code: Below elbow, molded double wall split socket, stump activated locking hinge, half cuff
L6130 is the HCPCS Level II code for below elbow, molded double wall split socket, stump activated locking hinge, half cuff. The 2026 Medicare DMEPOS fee schedule pays $1,564.55 to $5,581.92 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 4 of 4 L61 codes (family range $2,650.46–$3,584.15).
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 | 1982-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L6130
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1,564.55 | $5,581.92 | $4,225.63 | $3,169.22 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $5,220.15 | — |
| AL | — | $3,169.22 | — |
| AR | — | $3,205.49 | — |
| AZ | — | $4,225.63 | — |
| CA | — | $4,225.63 | — |
| CO | — | $3,463.03 | — |
| CT | — | $3,554.58 | — |
| DC | — | $3,169.22 | — |
| DE | — | $3,169.22 | — |
| FL | — | $3,169.22 | — |
| GA | — | $3,169.22 | — |
| HI | — | $5,581.92 | — |
| IA | — | $3,630.90 | — |
| ID | — | $4,225.63 | — |
| IL | — | $3,910.12 | — |
| IN | — | $3,910.12 | — |
| KS | — | $3,630.90 | — |
| KY | — | $3,169.22 | — |
| LA | — | $3,205.49 | — |
| MA | — | $3,554.58 | — |
| MD | — | $3,169.22 | — |
| ME | — | $3,554.58 | — |
| MI | — | $3,910.12 | — |
| MN | — | $3,910.12 | — |
| MO | — | $3,630.90 | — |
| MS | — | $3,169.22 | — |
| MT | — | $3,463.03 | — |
| NC | — | $3,169.22 | — |
| ND | — | $3,463.03 | — |
| NE | — | $3,630.90 | — |
| NH | — | $3,554.58 | — |
| NJ | — | $3,917.63 | — |
| NM | — | $3,205.49 | — |
| NV | — | $4,225.63 | — |
| NY | — | $3,917.63 | — |
| OH | — | $3,910.12 | — |
| OK | — | $3,205.49 | — |
| OR | — | $4,225.63 | — |
| PA | — | $3,169.22 | — |
| PR | — | $1,564.55 | — |
| RI | — | $3,554.58 | — |
| SC | — | $3,169.22 | — |
| SD | — | $3,463.03 | — |
| TN | — | $3,169.22 | — |
| TX | — | $3,205.49 | — |
| UT | — | $3,463.03 | — |
| VA | — | $3,169.22 | — |
| VI | — | $3,917.63 | — |
| VT | — | $3,554.58 | — |
| WA | — | $4,225.63 | — |
| WI | — | $3,910.12 | — |
| WV | — | $3,169.22 | — |
| WY | — | $3,463.03 | — |
How the L6130 fee compares
| Measure | Value |
|---|---|
| Rank among 4 L61 codes (lowest = 1) | 4 |
| Family fee range (average of state fees) | $2,650.46–$3,584.15 |
| 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 L6130
- 2026-01-01: Average state fee rose 2.0%: $3,513.87 to $3,584.15
- 1982-01-01: L6130 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 L6130?
L6130 is the HCPCS Level II code for below elbow, molded double wall split socket, stump activated locking hinge, half cuff. Short descriptor: "Elbow stump activated lock h".
How much does Medicare pay for L6130?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1,564.55–$5,581.92. Rural fees can be higher.
Does Medicare cover L6130?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6130 change in 2026?
The average non-rural state fee moved from $3,513.87 in 2025 to $3,584.15 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6130 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L61 codes
- L6100 — Below elbow, molded socket, flexible elbow hinge, triceps pad ($1,414.34–$3,141.59)
- L6110 — Below elbow, molded socket, (muenster or northwestern suspension types) ($1,431.47–$3,721.84)
- L6120 — Below elbow, molded double wall split socket, step-up hinges, half cuff ($1,533.73–$4,181.56)
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Next steps
- Run a reimbursement report for a device billed under L6130
- Watch L6130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6130
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.