L3980 — Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment
L3980 is a HCPCS Level II code for upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment. 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 L3980 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
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
- DME supplier
- 2 units MAI 2 — Date of Service Edit: Policy · Anatomic Consideration
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 L3980
- Long descriptor
- Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment
- Short descriptor
- Up ext fx orthos humeral nos
- Added
- January 1, 1982
- 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 L3980
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L3980 is not quite right, the correct code is very often within a few positions of it.
- L3962Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment
- L3967Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3971Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3973Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3975Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3976Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3977Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3978Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
- L3981Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments
- L3982Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment
- L3984Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment
- L3995Addition to upper extremity orthosis, sock, fracture or equal, each
- L3999Upper limb orthosis, not otherwise specified
- L4000Replace girdle for spinal orthosis (ctlso or so)
- L4002Replacement strap, any orthosis, includes all components, any length, any type
- L4010Replace trilateral socket brim
Questions about L3980
What is HCPCS code L3980?
L3980 is a HCPCS Level II code for upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L3980?
The CMS HCPCS file marks L3980 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.