L7191 HCPCS code: Electronic elbow, child, variety village or equal, myoelectronically controlled
L7191 is the HCPCS Level II code for electronic elbow, child, variety village or equal, myoelectronically controlled. The 2026 Medicare DMEPOS fee schedule pays $10,261.32 to $14,868.87 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 5 of 7 L71 codes (family range $7,789.04–$49,092.41).
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 | 1989-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L7191
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $10,261.32 | $14,868.87 | $15,087.75 | $11,315.81 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $10,261.32 | — |
| AL | — | $11,315.81 | — |
| AR | — | $14,868.87 | — |
| AZ | — | $11,315.81 | — |
| CA | — | $11,315.81 | — |
| CO | — | $14,510.42 | — |
| CT | — | $12,542.82 | — |
| DC | — | $12,088.38 | — |
| DE | — | $12,088.38 | — |
| FL | — | $11,315.81 | — |
| GA | — | $11,315.81 | — |
| HI | — | $10,972.51 | — |
| IA | — | $12,983.51 | — |
| ID | — | $11,315.81 | — |
| IL | — | $13,769.77 | — |
| IN | — | $13,769.77 | — |
| KS | — | $12,983.51 | — |
| KY | — | $11,315.81 | — |
| LA | — | $14,868.87 | — |
| MA | — | $12,542.82 | — |
| MD | — | $12,088.38 | — |
| ME | — | $12,542.82 | — |
| MI | — | $13,769.77 | — |
| MN | — | $13,769.77 | — |
| MO | — | $12,983.51 | — |
| MS | — | $11,315.81 | — |
| MT | — | $14,510.42 | — |
| NC | — | $11,315.81 | — |
| ND | — | $14,510.42 | — |
| NE | — | $12,983.51 | — |
| NH | — | $12,542.82 | — |
| NJ | — | $13,827.39 | — |
| NM | — | $14,868.87 | — |
| NV | — | $11,315.81 | — |
| NY | — | $13,827.39 | — |
| OH | — | $13,769.77 | — |
| OK | — | $14,868.87 | — |
| OR | — | $11,315.81 | — |
| PA | — | $12,088.38 | — |
| PR | — | $13,827.33 | — |
| RI | — | $12,542.82 | — |
| SC | — | $11,315.81 | — |
| SD | — | $14,510.42 | — |
| TN | — | $11,315.81 | — |
| TX | — | $14,868.87 | — |
| UT | — | $14,510.42 | — |
| VA | — | $12,088.38 | — |
| VI | — | $13,827.39 | — |
| VT | — | $12,542.82 | — |
| WA | — | $11,315.81 | — |
| WI | — | $13,769.77 | — |
| WV | — | $12,088.38 | — |
| WY | — | $14,510.42 | — |
How the L7191 fee compares
| Measure | Value |
|---|---|
| Rank among 7 L71 codes (lowest = 1) | 5 |
| Family fee range (average of state fees) | $7,789.04–$49,092.41 |
| Rural fee uplift | — |
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 L7191
- 2026-01-01: Average state fee rose 2.0%: $12,554.78 to $12,805.88
- 1989-01-01: L7191 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 L7191?
L7191 is the HCPCS Level II code for electronic elbow, child, variety village or equal, myoelectronically controlled. Short descriptor: "Elbow child myoelectronic ct".
How much does Medicare pay for L7191?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $10,261.32–$14,868.87. Rural fees can be higher.
Does Medicare cover L7191?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L7191 change in 2026?
The average non-rural state fee moved from $12,554.78 in 2025 to $12,805.88 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L7191 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L71 codes
- L7170 — Electronic elbow, hosmer or equal, switch controlled ($7,052.45–$9,571.18)
- L7180 — Electronic elbow, microprocessor sequential control of elbow and terminal device ($18,180.91–$50,007.15)
- L7181 — Electronic elbow, microprocessor simultaneous control of elbow and terminal device ($48,155.50–$52,971.00)
- L7185 — Electronic elbow, adolescent, variety village or equal, switch controlled ($7,269.08–$9,692.10)
- L7186 — Electronic elbow, child, variety village or equal, switch controlled ($10,430.01–$14,162.40)
- L7190 — Electronic elbow, adolescent, variety village or equal, myoelectronically controlled ($9,330.76–$13,407.96)
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Next steps
- Run a reimbursement report for a device billed under L7191
- Watch L7191 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L7191
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.