L6386 HCPCS code: Immediate post surgical or early fitting, each additional cast change and realignment
L6386 is the HCPCS Level II code for immediate post surgical or early fitting, each additional cast change and realignment. The 2026 Medicare DMEPOS fee schedule pays $491.64 to $1,427.66 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 1 of 11 L63 codes (family range $573.91–$5,405.67).
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 L6386
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $491.64 | $1,427.66 | $655.52 | $491.64 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $660.38 | — |
| AL | — | $491.64 | — |
| AR | — | $547.30 | — |
| AZ | — | $655.52 | — |
| CA | — | $655.52 | — |
| CO | — | $491.64 | — |
| CT | — | $553.70 | — |
| DC | — | $560.51 | — |
| DE | — | $560.51 | — |
| FL | — | $491.64 | — |
| GA | — | $491.64 | — |
| HI | — | $706.16 | — |
| IA | — | $558.94 | — |
| ID | — | $565.14 | — |
| IL | — | $575.71 | — |
| IN | — | $575.71 | — |
| KS | — | $558.94 | — |
| KY | — | $491.64 | — |
| LA | — | $547.30 | — |
| MA | — | $553.70 | — |
| MD | — | $560.51 | — |
| ME | — | $553.70 | — |
| MI | — | $575.71 | — |
| MN | — | $575.71 | — |
| MO | — | $558.94 | — |
| MS | — | $491.64 | — |
| MT | — | $491.64 | — |
| NC | — | $491.64 | — |
| ND | — | $491.64 | — |
| NE | — | $558.94 | — |
| NH | — | $553.70 | — |
| NJ | — | $655.52 | — |
| NM | — | $547.30 | — |
| NV | — | $655.52 | — |
| NY | — | $655.52 | — |
| OH | — | $575.71 | — |
| OK | — | $547.30 | — |
| OR | — | $565.14 | — |
| PA | — | $560.51 | — |
| PR | — | $1,427.66 | — |
| RI | — | $553.70 | — |
| SC | — | $491.64 | — |
| SD | — | $491.64 | — |
| TN | — | $491.64 | — |
| TX | — | $547.30 | — |
| UT | — | $491.64 | — |
| VA | — | $560.51 | — |
| VI | — | $655.52 | — |
| VT | — | $553.70 | — |
| WA | — | $565.14 | — |
| WI | — | $575.71 | — |
| WV | — | $560.51 | — |
| WY | — | $491.64 | — |
How the L6386 fee compares
| Measure | Value |
|---|---|
| Rank among 11 L63 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $573.91–$5,405.67 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Nature of Equipment |
| outpatient hospital claims | 2 | Nature of Equipment |
What changed for L6386
- 2026-01-01: Average state fee rose 2.0%: $562.66 to $573.91
- 1988-01-01: L6386 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 L6386?
L6386 is the HCPCS Level II code for immediate post surgical or early fitting, each additional cast change and realignment. Short descriptor: "Postop ea cast chg & realign".
How much does Medicare pay for L6386?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $491.64–$1,427.66. Rural fees can be higher.
Does Medicare cover L6386?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6386 change in 2026?
The average non-rural state fee moved from $562.66 in 2025 to $573.91 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6386 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L63 codes
- L6300 — Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm ($2,658.47–$6,899.63)
- L6310 — Shoulder disarticulation, passive restoration (complete prosthesis) ($1,411.10–$5,563.52)
- L6320 — Shoulder disarticulation, passive restoration (shoulder cap only) ($1,002.06–$3,569.77)
- L6350 — Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm ($3,169.88–$6,936.42)
- L6360 — Interscapular thoracic, passive restoration (complete prosthesis) ($1,533.73–$7,462.35)
- L6370 — Interscapular thoracic, passive restoration (shoulder cap only) ($1,145.38–$3,911.96)
- L6380 — Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow ($1,425.59–$2,093.90)
- L6382 — Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow ($1,841.69–$3,426.39)
- L6384 — Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic ($2,334.16–$3,997.43)
- L6388 — Immediate post surgical or early fitting, application of rigid dressing only ($464.61–$717.61)
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Next steps
- Run a reimbursement report for a device billed under L6386
- Watch L6386 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6386
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.