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L8040 — Nasal prosthesis, provided by a non-physician

HCPCS Level II L-code · short descriptor: “Nasal prosthesis”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Prosthetics & orthotics
Prior authorization
Not on Medicare required-PA list
Status
Active (April 2026 HCPCS)

Prior authorization

Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

L8040 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $2812.57 to $3577.33 depending on state and rural status.

Former-CBA payment limits: ceiling $3632.60 · floor $2724.45

StateNon-ruralRural
AK$3373.86
AL$2992.53
AR$2950.58
AZ$3148.18
CA$3148.18
CO$2875.39
CT$3216.50
DC$3063.25
DE$3063.25
FL$2992.53
GA$2992.53
HI$3229.99
IA$2812.57
ID$3004.80
IL$3052.75
IN$3052.75
KS$2812.57
KY$2992.53
LA$2950.58
MA$3216.50
MD$3063.25
ME$3216.50
MI$3052.75
MN$3052.75
MO$2812.57
MS$2992.53
MT$2875.39
NC$2992.53
ND$2875.39
NE$2812.57
NH$3216.50
NJ$3340.74
NM$2950.58
NV$3148.18
NY$3340.74
OH$3052.75
OK$2950.58
OR$3004.80
PA$3063.25
PR$2831.61
RI$3216.50
SC$2992.53
SD$2875.39
TN$2992.53
TX$2950.58
UT$2875.39
VA$3063.25
VI$3577.33
VT$3216.50
WA$3004.80
WI$3052.75
WV$3063.25
WY$2875.39

KM Prosthetics & orthotics

Medicare allowable ranges from $2671.93 to $3398.45 depending on state and rural status.

Former-CBA payment limits: ceiling $3450.97 · floor $2588.23

StateNon-ruralRural
AK$3205.18
AL$2842.90
AR$2803.07
AZ$2990.76
CA$2990.76
CO$2731.60
CT$3055.67
DC$2910.13
DE$2910.13
FL$2842.90
GA$2842.90
HI$3068.49
IA$2671.93
ID$2854.55
IL$2900.10
IN$2900.10
KS$2671.93
KY$2842.90
LA$2803.07
MA$3055.67
MD$2910.13
ME$3055.67
MI$2900.10
MN$2900.10
MO$2671.93
MS$2842.90
MT$2731.60
NC$2842.90
ND$2731.60
NE$2671.93
NH$3055.67
NJ$3173.72
NM$2803.07
NV$2990.76
NY$3173.72
OH$2900.10
OK$2803.07
OR$2854.55
PA$2910.13
PR$2690.04
RI$3055.67
SC$2842.90
SD$2731.60
TN$2842.90
TX$2803.07
UT$2731.60
VA$2910.13
VI$3398.45
VT$3055.67
WA$2854.55
WI$2900.10
WV$2910.13
WY$2731.60

KN Prosthetics & orthotics

Medicare allowable ranges from $1125.03 to $1430.94 depending on state and rural status.

Former-CBA payment limits: ceiling $1453.04 · floor $1089.78

StateNon-ruralRural
AK$1349.55
AL$1197.01
AR$1180.19
AZ$1259.27
CA$1259.27
CO$1150.18
CT$1286.61
DC$1225.29
DE$1225.29
FL$1197.01
GA$1197.01
HI$1292.01
IA$1125.03
ID$1201.93
IL$1221.09
IN$1221.09
KS$1125.03
KY$1197.01
LA$1180.19
MA$1286.61
MD$1225.29
ME$1286.61
MI$1221.09
MN$1221.09
MO$1125.03
MS$1197.01
MT$1150.18
NC$1197.01
ND$1150.18
NE$1125.03
NH$1286.61
NJ$1336.31
NM$1180.19
NV$1259.27
NY$1336.31
OH$1221.09
OK$1180.19
OR$1201.93
PA$1225.29
PR$1132.66
RI$1286.61
SC$1197.01
SD$1150.18
TN$1197.01
TX$1180.19
UT$1150.18
VA$1225.29
VI$1430.94
VT$1286.61
WA$1201.93
WI$1221.09
WV$1225.29
WY$1150.18
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026. Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Common denial codes to watch

Related L-codes

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