L6955 HCPCS code: Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
L6955 is the HCPCS Level II code for above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device. The 2026 Medicare DMEPOS fee schedule pays $14,454.65 to $19,495.76 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 3% from 2022 to 2024 (31 to 32 services). In 2024, 29 suppliers billed Medicare for L6955 (purchases), serving 31 beneficiaries. Its average fee ranks 12 of 16 L69 codes (family range $879.26–$21,728.39).
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 | 1988-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L6955
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $14,454.65 | $19,495.76 | $19,495.76 | $14,621.82 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $14,454.65 | — |
| AL | — | $14,621.82 | — |
| AR | — | $16,060.21 | — |
| AZ | — | $14,621.82 | — |
| CA | — | $14,621.82 | — |
| CO | — | $19,495.76 | — |
| CT | — | $14,790.91 | — |
| DC | — | $15,000.96 | — |
| DE | — | $15,000.96 | — |
| FL | — | $14,621.82 | — |
| GA | — | $14,621.82 | — |
| HI | — | $15,456.46 | — |
| IA | — | $14,621.82 | — |
| ID | — | $14,621.82 | — |
| IL | — | $14,850.10 | — |
| IN | — | $14,850.10 | — |
| KS | — | $14,621.82 | — |
| KY | — | $14,621.82 | — |
| LA | — | $16,060.21 | — |
| MA | — | $14,790.91 | — |
| MD | — | $15,000.96 | — |
| ME | — | $14,790.91 | — |
| MI | — | $14,850.10 | — |
| MN | — | $14,850.10 | — |
| MO | — | $14,621.82 | — |
| MS | — | $14,621.82 | — |
| MT | — | $19,495.76 | — |
| NC | — | $14,621.82 | — |
| ND | — | $19,495.76 | — |
| NE | — | $14,621.82 | — |
| NH | — | $14,790.91 | — |
| NJ | — | $14,621.82 | — |
| NM | — | $16,060.21 | — |
| NV | — | $14,621.82 | — |
| NY | — | $14,621.82 | — |
| OH | — | $14,850.10 | — |
| OK | — | $16,060.21 | — |
| OR | — | $14,621.82 | — |
| PA | — | $15,000.96 | — |
| PR | — | $18,180.91 | — |
| RI | — | $14,790.91 | — |
| SC | — | $14,621.82 | — |
| SD | — | $19,495.76 | — |
| TN | — | $14,621.82 | — |
| TX | — | $16,060.21 | — |
| UT | — | $19,495.76 | — |
| VA | — | $15,000.96 | — |
| VI | — | $14,621.82 | — |
| VT | — | $14,790.91 | — |
| WA | — | $14,621.82 | — |
| WI | — | $14,850.10 | — |
| WV | — | $15,000.96 | — |
| WY | — | $19,495.76 | — |
How the L6955 fee compares
| Measure | Value |
|---|---|
| Rank among 16 L69 codes (lowest = 1) | 12 |
| Family fee range (average of state fees) | $879.26–$21,728.39 |
| Rural fee uplift | — |
Who bills L6955 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 29 |
| Referring clinicians | 31 |
| Medicare beneficiaries | 31 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 30 | 31 |
| 2023 | 30 | 33 |
| 2024 | 29 | 31 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L6955, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 31 | 31 | $12,864.76 | $10,148.72 |
| 2023 | 38 | 33 | $14,322.12 | $10,916.83 |
| 2024 | 32 | 31 | $13,998.13 | $10,712.99 |
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 L6955
- 2026-01-01: Average state fee rose 2.0%: $15,173.46 to $15,476.94
- 1988-01-01: L6955 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 L6955?
L6955 is the HCPCS Level II code for above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device. Short descriptor: "Above elbow myoelectronic ct".
How much does Medicare pay for L6955?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $14,454.65–$19,495.76. Rural fees can be higher.
Does Medicare cover L6955?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L6955 change in 2026?
The average non-rural state fee moved from $15,173.46 in 2025 to $15,476.94 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L6955 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L69 codes
- L6900 — Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining ($1,849.18–$2,681.07)
- L6905 — Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining ($1,797.45–$2,880.98)
- L6910 — Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining ($1,751.09–$3,997.14)
- L6915 — Hand restoration (shading, and measurements included), replacement glove for above ($766.41–$1,092.76)
- L6920 — Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device ($8,170.29–$10,469.46)
- L6925 — Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device ($8,819.66–$11,250.19)
- L6930 — Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device ($6,795.44–$10,435.11)
- L6935 — Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device ($8,604.01–$11,203.37)
- L6940 — Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device ($10,741.21–$14,321.62)
- L6945 — Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device ($12,487.36–$17,607.82)
- L6950 — Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device ($12,096.21–$17,607.82)
- L6960 — Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device ($14,747.21–$19,662.94)
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Next steps
- Run a reimbursement report for a device billed under L6955
- Watch L6955 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L6955
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.