L6500 HCPCS code: Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
L6500 is the HCPCS Level II code for above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping. The 2026 Medicare DMEPOS fee schedule pays $2,044.98 to $4,948.96 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. Medicare volume rose 9% from 2022 to 2023 (11 to 12 services). In 2023, 11 suppliers billed Medicare for L6500 (purchases), serving 0 beneficiaries. Its average fee ranks 7 of 9 L65 codes (family range $1,876.24–$6,041.39).
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 L6500
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $2,044.98 | $4,948.96 | $5,036.72 | $3,777.54 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $4,229.67 | — |
| AL | — | $3,970.50 | — |
| AR | — | $3,808.49 | — |
| AZ | — | $4,197.24 | — |
| CA | — | $4,197.24 | — |
| CO | — | $4,948.96 | — |
| CT | — | $4,260.84 | — |
| DC | — | $3,777.54 | — |
| DE | — | $3,777.54 | — |
| FL | — | $3,970.50 | — |
| GA | — | $3,970.50 | — |
| HI | — | $4,522.83 | — |
| IA | — | $4,603.02 | — |
| ID | — | $4,351.76 | — |
| IL | — | $4,300.25 | — |
| IN | — | $4,300.25 | — |
| KS | — | $4,603.02 | — |
| KY | — | $3,970.50 | — |
| LA | — | $3,808.49 | — |
| MA | — | $4,260.84 | — |
| MD | — | $3,777.54 | — |
| ME | — | $4,260.84 | — |
| MI | — | $4,300.25 | — |
| MN | — | $4,300.25 | — |
| MO | — | $4,603.02 | — |
| MS | — | $3,970.50 | — |
| MT | — | $4,948.96 | — |
| NC | — | $3,970.50 | — |
| ND | — | $4,948.96 | — |
| NE | — | $4,603.02 | — |
| NH | — | $4,260.84 | — |
| NJ | — | $3,914.18 | — |
| NM | — | $3,808.49 | — |
| NV | — | $4,197.24 | — |
| NY | — | $3,914.18 | — |
| OH | — | $4,300.25 | — |
| OK | — | $3,808.49 | — |
| OR | — | $4,351.76 | — |
| PA | — | $3,777.54 | — |
| PR | — | $2,044.98 | — |
| RI | — | $4,260.84 | — |
| SC | — | $3,970.50 | — |
| SD | — | $4,948.96 | — |
| TN | — | $3,970.50 | — |
| TX | — | $3,808.49 | — |
| UT | — | $4,948.96 | — |
| VA | — | $3,777.54 | — |
| VI | — | $3,914.18 | — |
| VT | — | $4,260.84 | — |
| WA | — | $4,351.76 | — |
| WI | — | $4,300.25 | — |
| WV | — | $3,777.54 | — |
| WY | — | $4,948.96 | — |
How the L6500 fee compares
| Measure | Value |
|---|---|
| Rank among 9 L65 codes (lowest = 1) | 7 |
| Family fee range (average of state fees) | $1,876.24–$6,041.39 |
| Rural fee uplift | — |
Who bills L6500 (2023)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 11 |
| Referring clinicians | 11 |
| Medicare beneficiaries | 0 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 10 | 11 |
| 2023 | 11 | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L6500, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 11 | 11 | $3,720.15 | $2,922.38 |
| 2023 | 12 | 0 | $3,778.16 | $2,920.90 |
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 L6500
- 2026-01-01: Average state fee rose 2.0%: $4,090.47 to $4,172.28
- 1982-01-01: L6500 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 L6500?
L6500 is the HCPCS Level II code for above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping. Short descriptor: "Above elbow prosth tiss shap".
How much does Medicare pay for L6500?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $2,044.98–$4,948.96. Rural fees can be higher.
Does Medicare cover L6500?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6500 change in 2026?
The average non-rural state fee moved from $4,090.47 in 2025 to $4,172.28 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6500 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L65 codes
- L6550 — Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping ($2,658.47–$7,452.41)
- L6570 — Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping ($3,169.88–$8,634.46)
- L6580 — Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model ($1,918.41–$2,486.04)
- L6582 — Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed ($1,684.94–$2,664.98)
- L6584 — Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model ($2,505.80–$3,426.39)
- L6586 — Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed ($2,305.78–$3,045.67)
- L6588 — Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model ($3,460.36–$4,387.49)
- L6590 — Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed ($3,286.61–$3,970.24)
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 L6500
- Watch L6500 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6500
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.