HCPCS Range Additions for Upper Extremity Prosthetics

• 1 Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal) ( L7400 )

• 2 Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) ( L7401 )

• 3 Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal) ( L7402 )

• 4 Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material ( L7403 )

• 5 Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material ( L7404 )

• 6 Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material ( L7405 )