| Code | Description | States | Median rate |
|---|---|---|---|
| L7007 | Electric hand, switch or myoelectric controlled, adult | 31 | $3,397.40 |
| L7008 | Electric hand, switch or myoelectric, controlled, pediatric | 32 | $5,559.86 |
| L7009 | Electric hook, switch or myoelectric controlled, adult | 33 | $3,455.20 |
| L7040 | Prehensile actuator, switch controlled | 35 | $2,771.56 |
| L7045 | Electric hook, switch or myoelectric controlled, pediatric | 34 | $1,551.99 |
| L7170 | Electronic elbow, hosmer or equal, switch controlled | 35 | $5,692.81 |
| L7180 | Electronic elbow, microprocessor sequential control of elbow and terminal device | 32 | $35,077.89 |
| L7181 | Electronic elbow, microprocessor simultaneous control of elbow and terminal device | 25 | $38,900.50 |
| L7185 | Electronic elbow, adolescent, variety village or equal, switch controlled | 34 | $5,890.45 |
| L7186 | Electronic elbow, child, variety village or equal, switch controlled | 34 | $9,018.14 |
| L7190 | Electronic elbow, adolescent, variety village or equal, myoelectronically controlled | 33 | $7,650.61 |
| L7191 | Electronic elbow, child, variety village or equal, myoelectronically controlled | 33 | $9,674.94 |
| L7259 | Electronic wrist rotator, any type | 27 | $4,083.81 |
| L7360 | Six volt battery, each | 36 | $257.33 |
| L7362 | Battery charger, six volt, each | 37 | $263.64 |
| L7364 | Twelve volt battery, each | 35 | $479.47 |
| L7366 | Battery charger, twelve volt, each | 35 | $646.74 |
| L7367 | Lithium ion battery, rechargeable, replacement | 33 | $374.32 |
| L7368 | Lithium ion battery charger, replacement only | 35 | $470.52 |
| L7400 | Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal) | 43 | $291.79 |
| L7401 | Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) | 37 | $316.25 |
| L7402 | Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal) | 37 | $352.77 |
| L7403 | Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material | 42 | $354.06 |
| L7404 | Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material | 38 | $518.19 |
| L7405 | Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material | 37 | $692.07 |
| L7406 | Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) | 17 | $2,903.00 |
| L7510 | Repair of prosthetic device, repair or replace minor parts | 20 | $35.89 |
| L7520 | Repair prosthetic device, labor component, per 15 minutes | 39 | $28.24 |
| L7700 | Gasket or seal, for use with prosthetic socket insert, any type, each | 35 | $135.89 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.