L6691 HCPCS code: Upper extremity addition, removable insert, each
L6691 is the HCPCS Level II code for upper extremity addition, removable insert, each. The 2026 Medicare DMEPOS fee schedule pays $422.60 to $809.00 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 26 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 | 1988-01-01 |
2026 Medicare DMEPOS fee schedule for L6691
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $422.60 | $809.00 | $563.46 | $422.60 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $574.42 | — |
| AL | — | $424.15 | — |
| AR | — | $422.60 | — |
| AZ | — | $562.37 | — |
| CA | — | $562.37 | — |
| CO | — | $422.60 | — |
| CT | — | $563.46 | — |
| DC | — | $534.24 | — |
| DE | — | $534.24 | — |
| FL | — | $424.15 | — |
| GA | — | $424.15 | — |
| HI | — | $614.26 | — |
| IA | — | $502.76 | — |
| ID | — | $485.59 | — |
| IL | — | $432.88 | — |
| IN | — | $432.88 | — |
| KS | — | $502.76 | — |
| KY | — | $424.15 | — |
| LA | — | $422.60 | — |
| MA | — | $563.46 | — |
| MD | — | $534.24 | — |
| ME | — | $563.46 | — |
| MI | — | $432.88 | — |
| MN | — | $432.88 | — |
| MO | — | $502.76 | — |
| MS | — | $424.15 | — |
| MT | — | $422.60 | — |
| NC | — | $424.15 | — |
| ND | — | $422.60 | — |
| NE | — | $502.76 | — |
| NH | — | $563.46 | — |
| NJ | — | $451.22 | — |
| NM | — | $422.60 | — |
| NV | — | $562.37 | — |
| NY | — | $451.22 | — |
| OH | — | $432.88 | — |
| OK | — | $422.60 | — |
| OR | — | $485.59 | — |
| PA | — | $534.24 | — |
| PR | — | $809.00 | — |
| RI | — | $563.46 | — |
| SC | — | $424.15 | — |
| SD | — | $422.60 | — |
| TN | — | $424.15 | — |
| TX | — | $422.60 | — |
| UT | — | $422.60 | — |
| VA | — | $534.24 | — |
| VI | — | $451.22 | — |
| VT | — | $563.46 | — |
| WA | — | $485.59 | — |
| WI | — | $432.88 | — |
| WV | — | $534.24 | — |
| WY | — | $422.60 | — |
How the L6691 fee compares
| Measure | Value |
|---|---|
| Rank among 50 L66 codes (lowest = 1) | 26 |
| Family fee range (average of state fees) | $61.02–$4,614.32 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Clinical: Data |
| outpatient hospital claims | 2 | Clinical: Data |
What changed for L6691
- 2026-01-01: Average state fee rose 2.0%: $475.98 to $485.50
- 1988-01-01: L6691 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 L6691?
L6691 is the HCPCS Level II code for upper extremity addition, removable insert, each. Short descriptor: "Removable insert each".
How much does Medicare pay for L6691?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $422.60–$809.00. Rural fees can be higher.
Does Medicare cover L6691?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6691 change in 2026?
The average non-rural state fee moved from $475.98 in 2025 to $485.50 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6691 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)
- L6621 — Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device ($2,748.98–$3,023.86)
- 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)
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Next steps
- Run a reimbursement report for a device billed under L6691
- Watch L6691 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6691
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.