L7406 HCPCS code: Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)
L7406 is the HCPCS Level II code for addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit). The 2026 Medicare DMEPOS fee schedule pays $3,150.07 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 7 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 | 2025-04-01 |
| Last action effective | 2025-10-01 |
2026 Medicare DMEPOS fee schedule for L7406
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $3,150.07 | $3,150.07 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $3,150.07 | — |
| AL | — | $3,150.07 | — |
| AR | — | $3,150.07 | — |
| AZ | — | $3,150.07 | — |
| CA | — | $3,150.07 | — |
| CO | — | $3,150.07 | — |
| CT | — | $3,150.07 | — |
| DC | — | $3,150.07 | — |
| DE | — | $3,150.07 | — |
| FL | — | $3,150.07 | — |
| GA | — | $3,150.07 | — |
| HI | — | $3,150.07 | — |
| IA | — | $3,150.07 | — |
| ID | — | $3,150.07 | — |
| IL | — | $3,150.07 | — |
| IN | — | $3,150.07 | — |
| KS | — | $3,150.07 | — |
| KY | — | $3,150.07 | — |
| LA | — | $3,150.07 | — |
| MA | — | $3,150.07 | — |
| MD | — | $3,150.07 | — |
| ME | — | $3,150.07 | — |
| MI | — | $3,150.07 | — |
| MN | — | $3,150.07 | — |
| MO | — | $3,150.07 | — |
| MS | — | $3,150.07 | — |
| MT | — | $3,150.07 | — |
| NC | — | $3,150.07 | — |
| ND | — | $3,150.07 | — |
| NE | — | $3,150.07 | — |
| NH | — | $3,150.07 | — |
| NJ | — | $3,150.07 | — |
| NM | — | $3,150.07 | — |
| NV | — | $3,150.07 | — |
| NY | — | $3,150.07 | — |
| OH | — | $3,150.07 | — |
| OK | — | $3,150.07 | — |
| OR | — | $3,150.07 | — |
| PA | — | $3,150.07 | — |
| PR | — | $3,150.07 | — |
| RI | — | $3,150.07 | — |
| SC | — | $3,150.07 | — |
| SD | — | $3,150.07 | — |
| TN | — | $3,150.07 | — |
| TX | — | $3,150.07 | — |
| UT | — | $3,150.07 | — |
| VA | — | $3,150.07 | — |
| VI | — | $3,150.07 | — |
| VT | — | $3,150.07 | — |
| WA | — | $3,150.07 | — |
| WI | — | $3,150.07 | — |
| WV | — | $3,150.07 | — |
| WY | — | $3,150.07 | — |
How the L7406 fee compares
| Measure | Value |
|---|---|
| Rank among 7 L74 codes (lowest = 1) | 7 |
| 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 L7406
- October 2025: Descriptor revised (Was: Addition to upper extremity, user adjustable, mechanical, residual limb volume management system)
- April 2025: Code appears in this HCPCS release
- 2025-10-01: Last CMS action: long description changed
- 2025-04-01: L7406 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 L7406?
L7406 is the HCPCS Level II code for addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit). Short descriptor: "Add upp ext mec limb vol lam".
How much does Medicare pay for L7406?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $3,150.07. Rural fees can be higher.
Does Medicare cover L7406?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of L7406 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
Related L74 codes
- L7400 — Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal) ($368.35–$405.17)
- 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)
- L7499 — Upper extremity prosthesis, not otherwise specified
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Next steps
- Run a reimbursement report for a device billed under L7406
- Watch L7406 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L7406
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.