L6036 – Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement

Long description

Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement

Short description

Prosthetic thumb mechanical

Pricing indicator

38 Orthotics, prosthetics, prosthetic devices & vision services

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

D1F Prosthetic/Orthotic devices

Added

October 1, 2025

Last change

October 1, 2025 – No change

Nearby L codes

• L6028 – Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692
• L6029 – Upper extremity addition, test socket/interface, partial hand including fingers
• L6030 – Upper extremity addition, external frame, partial hand including fingers
• L6031 – Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power
• L6032 – Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)
• L6033 – Addition to upper extremity prosthesis, partial hand including fingers, acrylic material
• L6034 – Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692
• L6035 – Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement
• L6037 – Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers
• L6038 – Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material
• L6039 – Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb
• L6050 – Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad
• L6055 – Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad
• L6100 – Below elbow, molded socket, flexible elbow hinge, triceps pad
• L6110 – Below elbow, molded socket, (muenster or northwestern suspension types)
• L6120 – Below elbow, molded double wall split socket, step-up hinges, half cuff