L6621 HCPCS code: Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device
L6621 is the HCPCS Level II code for upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device. The 2026 Medicare DMEPOS fee schedule pays $2,748.98 to $3,023.86 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 7% from 2022 to 2024 (105 to 112 services). In 2024, 78 suppliers billed Medicare for L6621 (purchases), serving 90 beneficiaries. Its average fee ranks 45 of 50 L66 codes (family range $61.02–$4,614.32).
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 | 2006-01-01 |
| Last action effective | 2006-01-01 |
2026 Medicare DMEPOS fee schedule for L6621
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $2,748.98 | $3,023.86 | $3,354.73 | $2,516.05 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $2,748.98 | — |
| AL | — | $2,831.71 | — |
| AR | — | $2,831.48 | — |
| AZ | — | $2,748.98 | — |
| CA | — | $2,748.98 | — |
| CO | — | $2,847.38 | — |
| CT | — | $2,748.98 | — |
| DC | — | $2,748.98 | — |
| DE | — | $2,748.98 | — |
| FL | — | $2,831.71 | — |
| GA | — | $2,831.71 | — |
| HI | — | $2,748.98 | — |
| IA | — | $2,802.69 | — |
| ID | — | $2,748.98 | — |
| IL | — | $2,816.50 | — |
| IN | — | $2,816.50 | — |
| KS | — | $2,802.69 | — |
| KY | — | $2,831.71 | — |
| LA | — | $2,831.48 | — |
| MA | — | $2,748.98 | — |
| MD | — | $2,748.98 | — |
| ME | — | $2,748.98 | — |
| MI | — | $2,816.50 | — |
| MN | — | $2,816.50 | — |
| MO | — | $2,802.69 | — |
| MS | — | $2,831.71 | — |
| MT | — | $2,847.38 | — |
| NC | — | $2,831.71 | — |
| ND | — | $2,847.38 | — |
| NE | — | $2,802.69 | — |
| NH | — | $2,748.98 | — |
| NJ | — | $2,748.98 | — |
| NM | — | $2,831.48 | — |
| NV | — | $2,748.98 | — |
| NY | — | $2,748.98 | — |
| OH | — | $2,816.50 | — |
| OK | — | $2,831.48 | — |
| OR | — | $2,748.98 | — |
| PA | — | $2,748.98 | — |
| PR | — | $3,023.86 | — |
| RI | — | $2,748.98 | — |
| SC | — | $2,831.71 | — |
| SD | — | $2,847.38 | — |
| TN | — | $2,831.71 | — |
| TX | — | $2,831.48 | — |
| UT | — | $2,847.38 | — |
| VA | — | $2,748.98 | — |
| VI | — | $3,023.86 | — |
| VT | — | $2,748.98 | — |
| WA | — | $2,748.98 | — |
| WI | — | $2,816.50 | — |
| WV | — | $2,748.98 | — |
| WY | — | $2,847.38 | — |
How the L6621 fee compares
| Measure | Value |
|---|---|
| Rank among 50 L66 codes (lowest = 1) | 45 |
| Family fee range (average of state fees) | $61.02–$4,614.32 |
| Rural fee uplift | — |
Who bills L6621 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 78 |
| Referring clinicians | 89 |
| Medicare beneficiaries | 90 |
| States with claims | 3 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 76 | 92 |
| 2023 | 83 | 103 |
| 2024 | 78 | 90 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L6621, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 105 | 92 | $2,404.64 | $1,878.90 |
| 2023 | 119 | 103 | $2,607.43 | $2,044.23 |
| 2024 | 112 | 90 | $2,678.07 | $2,080.08 |
States with the most L6621 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 18 | $2,125.35 |
| California | 14 | $2,072.29 |
| Florida | 11 | $2,125.52 |
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 L6621
- 2026-01-01: Average state fee rose 2.0%: $2,747.51 to $2,802.46
- 2006-01-01: L6621 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 L6621?
L6621 is the HCPCS Level II code for upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device. Short descriptor: "Flex/ext wrist w/wo friction".
How much does Medicare pay for L6621?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $2,748.98–$3,023.86. Rural fees can be higher.
Does Medicare cover L6621?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6621 change in 2026?
The average non-rural state fee moved from $2,747.51 in 2025 to $2,802.46 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6621 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L66 codes
- L6600 — Upper extremity additions, polycentric hinge, pair ($153.44–$409.35)
- L6605 — Upper extremity additions, single pivot hinge, pair ($133.09–$425.09)
- L6610 — Upper extremity additions, flexible metal hinge, pair ($122.80–$355.20)
- L6611 — Addition to upper extremity prosthesis, external powered, additional switch, any type ($494.85–$544.35)
- L6615 — Upper extremity addition, disconnect locking wrist unit ($122.80–$263.80)
- L6616 — Upper extremity addition, additional disconnect insert for locking wrist unit, each ($76.10–$105.88)
- L6620 — Upper extremity addition, flexion/extension wrist unit, with or without friction ($265.71–$513.87)
- L6623 — Upper extremity addition, spring assisted rotational wrist unit with latch release ($142.76–$1,047.08)
- L6624 — Upper extremity addition, flexion/extension and rotation wrist unit ($4,526.27–$4,978.89)
- L6625 — Upper extremity addition, rotation wrist unit with cable lock ($286.30–$1,187.86)
- L6628 — Upper extremity addition, quick disconnect hook adapter, otto bock or equal ($66.65–$781.97)
- L6629 — Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal ($104.71–$238.81)
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 L6621
- Watch L6621 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6621
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.