L3650 — Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf
L3650 is a HCPCS Level II code for shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of L3650 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
- DME supplier
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for L3650
- Long descriptor
- Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf
- Short descriptor
- So 8 abd restraint pre ots
- Added
- January 1, 1986
- BETOS
- D1F
- Pricing indicator
- 38 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Orthotics, prosthetics, prosthetic devices and vision services. Price subject to floors and ceilings.
Codes adjacent to L3650
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L3650 is not quite right, the correct code is very often within a few positions of it.
- L3590Orthopedic shoe addition, convert firm shoe counter to soft counter
- L3595Orthopedic shoe addition, march bar
- L3600Transfer of an orthosis from one shoe to another, caliper plate, existing
- L3610Transfer of an orthosis from one shoe to another, caliper plate, new
- L3620Transfer of an orthosis from one shoe to another, solid stirrup, existing
- L3630Transfer of an orthosis from one shoe to another, solid stirrup, new
- L3640Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes
- L3649Orthopedic shoe, modification, addition or transfer, not otherwise specified
- L3660Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf
- L3670Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf
- L3671Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3674Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3675Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf
- L3677Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
- L3678Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf
- L3702Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
Questions about L3650
What is HCPCS code L3650?
L3650 is a HCPCS Level II code for shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L3650?
The CMS HCPCS file marks L3650 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.