L7404 – Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
HCPCS Level II code · L codes: Orthotic and Prosthetic Procedures and Devices
HCPCS codeL7404
- Long description
- Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material
- Short description
- Add ue prost a/e acrylic
- Pricing indicator
38Orthotics, prosthetics, prosthetic devices & vision services- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 2006
- Last change
- January 1, 2006 – No change
Frequently asked questions
What is HCPCS code L7404?
L7404 is a HCPCS Level II code for addition to upper extremity prosthesis, above elbow disarticulation, acrylic material.
Does Medicare cover L7404?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby L codes
- L7364 – Twelve volt battery, each
- L7366 – Battery charger, twelve volt, each
- L7367 – Lithium ion battery, rechargeable, replacement
- L7368 – Lithium ion battery charger, replacement only
- L7400 – Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)
- L7401 – Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)
- L7402 – Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)
- L7403 – Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material
- L7405 – Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material
- L7406 – Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)
- L7499 – Upper extremity prosthesis, not otherwise specified
- L7510 – Repair of prosthetic device, repair or replace minor parts
- L7520 – Repair prosthetic device, labor component, per 15 minutes
- L7600 – Prosthetic donning sleeve, any material, each
- L7700 – Gasket or seal, for use with prosthetic socket insert, any type, each
- L7900 – Male vacuum erection system
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.