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
- Face-to-face & WOPD
- Not on the required list
- MUE unit limit
- 1
- Status
- Active (HCPCS Level II October 2026)
Prior authorization
Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-27; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
Order readiness — what the written order must contain
Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):
- Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
- General description of the item (42 CFR 410.38(d)(1)(i)(B))
- Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
- Order date (42 CFR 410.38(d)(1)(i)(D))
- Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
- Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))
Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-27; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.
Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.
L8040 Medicare fee schedule (October 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
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps L8040 at 1 unit per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Anatomic Consideration.
Common denial codes to watch
Related L-codes
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