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    v1.0.28
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l6970-interscapular-thoracic-external-power-prosthesis
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    HCPCS L6970: Interscapular-Thoracic External Power Upper-Limb Prosthesis

    HCPCS Level II code L6970 describes an external power interscapular-thoracic prosthesis system with a molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, Otto Bock or equivalent switch, cables, two batteries and one charger, and switch control of the terminal device; this item is a myoelectric/externally powered upper-limb prosthetic system intended for prosthetic fitting and replacement and is typically provided in an outpatient prosthetics/orthotics clinic or prosthetic specialty center as a durable medical equipment service.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria — Lymphedema Therapy and Training (Complete Decongestive Therapy; LVA), Therapy Services — Electric Stimulation for Pain, Swelling and Function in a Clinic Setting, Site of Care: Outpatient Hospital Setting for Physical and Occupational Therapy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 45-year-old right-hand dominant patient with a transhumeral amputation presents to an orthotics and prosthetics clinic for provision of an externally powered myoelectric-style prosthesis built on an interscapular-thoracic framework. The device described by L6970 includes a molded inner socket, removable shoulder shell and shoulder bulkhead, a humeral section with a mechanical elbow, powered forearm and terminal device controlled by an Otto Bock or equivalent switch system, associated cables, two batteries, and one charger. The clinical workflow begins with a prosthetist evaluation and cast or digital scan to fabricate the molded inner socket and interscapular-thoracic frame. Follow-up visits include fitting of the removable shoulder shell, alignment of the humeral and elbow components, programming and training with the switch control and batteries, and functional training with the occupational therapist for activities of daily living. Typical sites of service include an outpatient orthotics and prosthetics clinic, a hospital-based prosthetics department, or a rehabilitation center. The usual patient scenario involves prior surgical healing, residual limb maturity, and a documented need for an externally powered prosthesis to restore reach, prehension, and functional independence.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic management and training, upper extremity(s), initial encounter; prosthesis/orthosis training and fittingUsed for initial orthotic/prosthetic training and device education following provision of the prosthesis
    97763Orthotic management and training, upper extremity(s), subsequent encounter; training and fittingUsed for subsequent training sessions and functional adjustments after the initial fitting
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visitUsed to bill specific nonroutine supplies such as additional batteries, chargers, or replacement switch components when payer allows
    L8699Prosthetic device, not otherwise specified (HCPCS, miscellaneous) — (as a HCPCS)Used when an item or accessory related to the prosthesis does not have a specific HCPCS code and must be billed as miscellaneous
    92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; could be used only if concurrent communication training requiredRarely applicable; included when multidisciplinary rehab includes related services

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2080P0208XPediatric Infectious Diseases PhysicianA pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific know…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    163WG0100XGastroenterology Registered NurseNursing Service Providers · Registered Nurse
    284300000XSpecial HospitalA designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have…
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    1835P1300XPsychiatric PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and mo…
    103TP2700XDeactivated - Psychologist Psychotherapy

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    G54.4Lumbosacral root disorders, not elsewhere classified
    G56.41Causalgia of right upper limb
    G82.50Quadriplegia, unspecified
    G82.51Quadriplegia, C1-C4 complete
    G83.4Cauda equina syndrome
    M05.771Rheumatoid arthritis with rheumatoid factor of right ankle and foot without organ or systems involvement
    M24.211Disorder of ligament, right shoulder
    M24.212Disorder of ligament, left shoulder
    M24.219Disorder of ligament, unspecified shoulder
    M62.81Muscle weakness (generalized)

    Showing 1–10 of 22

    Related Payer Policy Updates

    Specialty: Physical Medicine, Rehab & Therapies1 / 2

    3 rows

    PolicyPayerEffective Date
    Clinical Review Criteria — Lymphedema Therapy and Training (Complete Decongestive Therapy; LVA)Kaiser Permanente2026-09-01
    Therapy Services — Electric Stimulation for Pain, Swelling and Function in a Clinic SettingCigna2026-08-15
    Site of Care: Outpatient Hospital Setting for Physical and Occupational TherapyCigna2026-08-15

    Related Codes

    HCPCS-L5000-PARTIAL-FOOT-SHOE-INSERT-LONGITUDINAL-ARCH-TOE-FILLER

    HCPCS Level II L5000: Partial Foot Shoe Insert with Longitudinal Arch, Toe Filler

    HCPCS-L5010-PARTIAL-FOOT-MOLDED-SOCKET-ANKLE-HEIGHT-TOE-FILLER

    HCPCS L5010: Partial Foot Molded Socket, Ankle Height, With Toe Filler

    HCPCS-L5020-PARTIAL-FOOT-MOLDED-SOCKET-TIBIAL-TUBERCLE-TOE-FILLER

    HCPCS L5020: Partial Foot Molded Socket with Toe Filler

    HCPCS-L5050-ANKLE-SYMES-MOLDED-SOCKET-SACH-FOOT

    HCPCS L5050: Ankle/Symes Molded Socket with SACH Foot

    HCPCS-L5060-ANKLE-SYMES-METAL-FRAME-MOLDED-LEATHER-SOCKET-ARTICULATED-ANKLE-FOOT

    HCPCS L5060: Ankle/Symes Metal Frame with Molded Leather Socket

    HCPCS-L5100-BELOW-KNEE-MOLDED-SOCKET-SHIN-SACH-FOOT

    HCPCS Level II L5100: Below-Knee Molded Socket with Shin and SACH Foot

    HCPCS-L5105-BELOW-KNEE-PLASTIC-SOCKET-SACH-FOOT

    HCPCS L5105: Below-Knee Plastic Socket Prosthesis with SACH Foot

    HCPCS-L5150-KNEE-DISARTICULATION-MOLDED-SOCKET-EXTERNAL-KNEE-SACH-FOOT

    HCPCS L5150: Knee Disarticulation Molded Socket with External Knee and SACH Foot

    HCPCS-L5160-KNEE-DISARTICULATION-MOLDED-SOCKET-BENT-KNEE-SACH-FOOT

    HCPCS Level II L5160: Knee Disarticulation Molded Socket, Bent Knee Configuration

    HCPCS-L5200-ABOVE-KNEE-MOLDED-SOCKET-SINGLE-AXIS-KNEE-SACH-FOOT

    HCPCS Level II L5200: Above-knee Prosthesis with Molded Socket and Single-axis Knee

    Showing 1–10 of 472

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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