L6665 — Upper extremity addition, teflon, or equal, cable lining
L6665 is a HCPCS Level II code for upper extremity addition, teflon, or equal, cable lining. 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 L6665 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
- 4 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- DME supplier
- 4 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
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 L6665
- Long descriptor
- Upper extremity addition, teflon, or equal, cable lining
- Short descriptor
- Teflon or equal cable lining
- 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 L6665
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L6665 is not quite right, the correct code is very often within a few positions of it.
- L6642Upper extremity addition, excursion amplifier, lever type
- L6645Upper extremity addition, shoulder flexion-abduction joint, each
- L6646Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system
- L6647Upper extremity addition, shoulder lock mechanism, body powered actuator
- L6648Upper extremity addition, shoulder lock mechanism, external powered actuator
- L6650Upper extremity addition, shoulder universal joint, each
- L6655Upper extremity addition, standard control cable, extra
- L6660Upper extremity addition, heavy duty control cable
- L6670Upper extremity addition, hook to hand, cable adapter
- L6672Upper extremity addition, harness, chest or shoulder, saddle type
- L6675Upper extremity addition, harness, (e.g., figure of eight type), single cable design
- L6676Upper extremity addition, harness, (e.g., figure of eight type), dual cable design
- L6677Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow
- L6680Upper extremity addition, test socket, wrist disarticulation or below elbow
- L6682Upper extremity addition, test socket, elbow disarticulation or above elbow
- L6684Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic
Questions about L6665
What is HCPCS code L6665?
L6665 is a HCPCS Level II code for upper extremity addition, teflon, or equal, cable lining. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L6665?
The CMS HCPCS file marks L6665 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.