L7400 HCPCS code: Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)
L7400 is the HCPCS Level II code for addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal). The 2026 Medicare DMEPOS fee schedule pays $368.35 to $405.17 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 1 of 7 L74 codes (family range $375.52–$3,150.07).
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 L7400
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $368.35 | $405.17 | $449.52 | $337.14 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $368.35 | — |
| AL | — | $379.46 | — |
| AR | — | $379.41 | — |
| AZ | — | $368.35 | — |
| CA | — | $368.35 | — |
| CO | — | $381.55 | — |
| CT | — | $368.35 | — |
| DC | — | $368.35 | — |
| DE | — | $368.35 | — |
| FL | — | $379.46 | — |
| GA | — | $379.46 | — |
| HI | — | $368.35 | — |
| IA | — | $375.53 | — |
| ID | — | $368.35 | — |
| IL | — | $377.39 | — |
| IN | — | $377.39 | — |
| KS | — | $375.53 | — |
| KY | — | $379.46 | — |
| LA | — | $379.41 | — |
| MA | — | $368.35 | — |
| MD | — | $368.35 | — |
| ME | — | $368.35 | — |
| MI | — | $377.39 | — |
| MN | — | $377.39 | — |
| MO | — | $375.53 | — |
| MS | — | $379.46 | — |
| MT | — | $381.55 | — |
| NC | — | $379.46 | — |
| ND | — | $381.55 | — |
| NE | — | $375.53 | — |
| NH | — | $368.35 | — |
| NJ | — | $368.35 | — |
| NM | — | $379.41 | — |
| NV | — | $368.35 | — |
| NY | — | $368.35 | — |
| OH | — | $377.39 | — |
| OK | — | $379.41 | — |
| OR | — | $368.35 | — |
| PA | — | $368.35 | — |
| PR | — | $405.17 | — |
| RI | — | $368.35 | — |
| SC | — | $379.46 | — |
| SD | — | $381.55 | — |
| TN | — | $379.46 | — |
| TX | — | $379.41 | — |
| UT | — | $381.55 | — |
| VA | — | $368.35 | — |
| VI | — | $405.17 | — |
| VT | — | $368.35 | — |
| WA | — | $368.35 | — |
| WI | — | $377.39 | — |
| WV | — | $368.35 | — |
| WY | — | $381.55 | — |
How the L7400 fee compares
| Measure | Value |
|---|---|
| Rank among 7 L74 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $375.52–$3,150.07 |
| 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 L7400
- 2026-01-01: Average state fee rose 2.0%: $368.16 to $375.52
- 2006-01-01: L7400 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 L7400?
L7400 is the HCPCS Level II code for addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal). Short descriptor: "Add ue prost be/wd, ultlite".
How much does Medicare pay for L7400?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $368.35–$405.17. Rural fees can be higher.
Does Medicare cover L7400?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L7400 change in 2026?
The average non-rural state fee moved from $368.16 in 2025 to $375.52 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L7400 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L74 codes
- L7401 — Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) ($412.39–$453.57)
- L7402 — Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal) ($445.33–$489.88)
- L7403 — Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material ($442.58–$486.81)
- L7404 — Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material ($668.02–$734.81)
- L7405 — Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material ($873.65–$961.06)
- L7406 — Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) ($3,150.07–$3,150.07)
- L7499 — Upper extremity prosthesis, not otherwise specified
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Next steps
- Run a reimbursement report for a device billed under L7400
- Watch L7400 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L7400
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.