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L6036 : HCPCS Code (2025) : JSON

L6036 : Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement ( Prosthetic thumb mechanical )

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HCPCS Code : L6036 – JSON Data Format

                    
{
  "HCPCS": {
    "HCPC": "L6036",
    "LongDescription": "Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement",
    "ShortDescription": "Prosthetic thumb mechanical",
    "PricingIndicators": {
      "PricingIndicator": {
        "PricingIndicatorName": "38",
        "PricingIndicatorCode": "Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) . Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings"
      }
    },
    "MPI": "A",
    "MultiplePricingIndicatorCode": "Not applicable as HCPCS priced under one methodology",
    "CIMs": null,
    "MCMs": "",
    "Statute": null,
    "LabCertifications": null,
    "XReferences": null,
    "Coverage": "C",
    "CoverageDescription": "Carrier judgment",
    "ASCPayGrp": null,
    "ASCPayGrpEffDate": null,
    "MOGPayGrp": null,
    "MOGPaymentGroupCode": null,
    "MOGPayInd": null,
    "MOGPaymentPolicyIndicator": null,
    "MOGEffDate": null,
    "ProcNote": null,
    "BETOS": "D1F",
    "BETOSDescription": "Prosthetic/Orthotic devices",
    "TypeOfServices": {
      "TypeOfService": {
        "TOS": "P",
        "TypeOfServiceCode": "Lump sum purchase of DME, prosthetics, orthotics"
      }
    },
    "AnestBaseUnits": "0",
    "CodeAddDate": "20251001",
    "ActionEffDate": "20251001",
    "TermDate": null,
    "ActionCode": "A",
    "ActionCodeDescription": "Add procedure or modifier code"
  }
}