L6890 — Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
L6890 is a HCPCS Level II code for addition to upper extremity prosthesis, glove for terminal device, any material, 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 L6890 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 3 — Date of Service Edit: Clinical · Anatomic Consideration
- DME supplier
- 2 units MAI 3 — Date of Service Edit: Clinical · 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 L6890
- Long descriptor
- Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment
- Short descriptor
- Prefab glove for term device
- 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 L6890
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L6890 is not quite right, the correct code is very often within a few positions of it.
- L6805Addition to terminal device, modifier wrist unit
- L6810Addition to terminal device, precision pinch device
- L6880Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)
- L6881Automatic grasp feature, addition to upper limb electric prosthetic terminal device
- L6882Microprocessor control feature, addition to upper limb prosthetic terminal device
- L6883Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power
- L6884Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
- L6885Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power
- L6895Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated
- L6900Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining
- L6905Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining
- L6910Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining
- L6915Hand restoration (shading, and measurements included), replacement glove for above
- L6920Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device
- L6925Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device
- L6930Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device
Questions about L6890
What is HCPCS code L6890?
L6890 is a HCPCS Level II code for addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L6890?
The CMS HCPCS file marks L6890 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.