L6320 — Shoulder disarticulation, passive restoration (shoulder cap only)
L6320 is a HCPCS Level II code for shoulder disarticulation, passive restoration (shoulder cap only). 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 L6320 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 L6320
- Long descriptor
- Shoulder disarticulation, passive restoration (shoulder cap only)
- Short descriptor
- Shoulder passive restor cap
- 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 L6320
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L6320 is not quite right, the correct code is very often within a few positions of it.
- L6110Below elbow, molded socket, (muenster or northwestern suspension types)
- L6120Below elbow, molded double wall split socket, step-up hinges, half cuff
- L6130Below elbow, molded double wall split socket, stump activated locking hinge, half cuff
- L6200Elbow disarticulation, molded socket, outside locking hinge, forearm
- L6205Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm
- L6250Above elbow, molded double wall socket, internal locking elbow, forearm
- L6300Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
- L6310Shoulder disarticulation, passive restoration (complete prosthesis)
- L6350Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm
- L6360Interscapular thoracic, passive restoration (complete prosthesis)
- L6370Interscapular thoracic, passive restoration (shoulder cap only)
- L6380Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow
- L6382Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow
- L6384Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic
- L6386Immediate post surgical or early fitting, each additional cast change and realignment
- L6388Immediate post surgical or early fitting, application of rigid dressing only
Questions about L6320
What is HCPCS code L6320?
L6320 is a HCPCS Level II code for shoulder disarticulation, passive restoration (shoulder cap only). It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L6320?
The CMS HCPCS file marks L6320 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.