L6205 HCPCS code: Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm
L6205 is the HCPCS Level II code for elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm. The 2026 Medicare DMEPOS fee schedule pays $4,458.17 to $6,051.96 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 3 of 3 L62 codes (family range $3,685.68–$5,062.33).
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 L6205
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $4,458.17 | $6,051.96 | $5,944.23 | $4,458.17 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $5,659.69 | — |
| AL | — | $4,458.17 | — |
| AR | — | $4,458.17 | — |
| AZ | — | $5,435.97 | — |
| CA | — | $5,435.97 | — |
| CO | — | $4,572.10 | — |
| CT | — | $5,640.91 | — |
| DC | — | $5,565.49 | — |
| DE | — | $5,565.49 | — |
| FL | — | $4,458.17 | — |
| GA | — | $4,458.17 | — |
| HI | — | $6,051.96 | — |
| IA | — | $4,579.66 | — |
| ID | — | $5,433.19 | — |
| IL | — | $5,556.38 | — |
| IN | — | $5,556.38 | — |
| KS | — | $4,579.66 | — |
| KY | — | $4,458.17 | — |
| LA | — | $4,458.17 | — |
| MA | — | $5,640.91 | — |
| MD | — | $5,565.49 | — |
| ME | — | $5,640.91 | — |
| MI | — | $5,556.38 | — |
| MN | — | $5,556.38 | — |
| MO | — | $4,579.66 | — |
| MS | — | $4,458.17 | — |
| MT | — | $4,572.10 | — |
| NC | — | $4,458.17 | — |
| ND | — | $4,572.10 | — |
| NE | — | $4,579.66 | — |
| NH | — | $5,640.91 | — |
| NJ | — | $5,012.28 | — |
| NM | — | $4,458.17 | — |
| NV | — | $5,435.97 | — |
| NY | — | $5,012.28 | — |
| OH | — | $5,556.38 | — |
| OK | — | $4,458.17 | — |
| OR | — | $5,433.19 | — |
| PA | — | $5,565.49 | — |
| PR | — | $4,663.64 | — |
| RI | — | $5,640.91 | — |
| SC | — | $4,458.17 | — |
| SD | — | $4,572.10 | — |
| TN | — | $4,458.17 | — |
| TX | — | $4,458.17 | — |
| UT | — | $4,572.10 | — |
| VA | — | $5,565.49 | — |
| VI | — | $5,012.28 | — |
| VT | — | $5,640.91 | — |
| WA | — | $5,433.19 | — |
| WI | — | $5,556.38 | — |
| WV | — | $5,565.49 | — |
| WY | — | $4,572.10 | — |
How the L6205 fee compares
| Measure | Value |
|---|---|
| Rank among 3 L62 codes (lowest = 1) | 3 |
| Family fee range (average of state fees) | $3,685.68–$5,062.33 |
| 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 L6205
- 2026-01-01: Average state fee rose 2.0%: $4,963.07 to $5,062.33
- 1988-01-01: L6205 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 L6205?
L6205 is the HCPCS Level II code for elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm. Short descriptor: "Elbow molded w/ expand inter".
How much does Medicare pay for L6205?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $4,458.17–$6,051.96. Rural fees can be higher.
Does Medicare cover L6205?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6205 change in 2026?
The average non-rural state fee moved from $4,963.07 in 2025 to $5,062.33 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6205 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L62 codes
- L6200 — Elbow disarticulation, molded socket, outside locking hinge, forearm ($1,993.43–$4,961.48)
- L6250 — Above elbow, molded double wall socket, internal locking elbow, forearm ($2,044.98–$5,285.01)
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Next steps
- Run a reimbursement report for a device billed under L6205
- Watch L6205 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6205
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.