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L8044 — Hemi-facial prosthesis, provided by a non-physician

HCPCS Level II L-code · short descriptor: “Hemi-facial 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.

L8044 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $4723.24 to $6007.51 depending on state and rural status.

Former-CBA payment limits: ceiling $6100.37 · floor $4575.28

StateNon-ruralRural
AK$5665.58
AL$5025.35
AR$4955.04
AZ$5287.15
CA$5287.15
CO$4828.95
CT$5401.83
DC$5144.24
DE$5144.24
FL$5025.35
GA$5025.35
HI$5424.38
IA$4723.24
ID$5046.33
IL$5126.08
IN$5126.08
KS$4723.24
KY$5025.35
LA$4955.04
MA$5401.83
MD$5144.24
ME$5401.83
MI$5126.08
MN$5126.08
MO$4723.24
MS$5025.35
MT$4828.95
NC$5025.35
ND$4828.95
NE$4723.24
NH$5401.83
NJ$5610.23
NM$4955.04
NV$5287.15
NY$5610.23
OH$5126.08
OK$4955.04
OR$5046.33
PA$5144.24
PR$4755.62
RI$5401.83
SC$5025.35
SD$4828.95
TN$5025.35
TX$4955.04
UT$4828.95
VA$5144.24
VI$6007.51
VT$5401.83
WA$5046.33
WI$5126.08
WV$5144.24
WY$4828.95

KM Prosthetics & orthotics

Medicare allowable ranges from $4487.12 to $5707.20 depending on state and rural status.

Former-CBA payment limits: ceiling $5795.36 · floor $4346.52

StateNon-ruralRural
AK$5382.31
AL$4774.11
AR$4707.28
AZ$5022.78
CA$5022.78
CO$4587.52
CT$5131.74
DC$4887.05
DE$4887.05
FL$4774.11
GA$4774.11
HI$5153.18
IA$4487.12
ID$4794.05
IL$4869.75
IN$4869.75
KS$4487.12
KY$4774.11
LA$4707.28
MA$5131.74
MD$4887.05
ME$5131.74
MI$4869.75
MN$4869.75
MO$4487.12
MS$4774.11
MT$4587.52
NC$4774.11
ND$4587.52
NE$4487.12
NH$5131.74
NJ$5329.73
NM$4707.28
NV$5022.78
NY$5329.73
OH$4869.75
OK$4707.28
OR$4794.05
PA$4887.05
PR$4517.84
RI$5131.74
SC$4774.11
SD$4587.52
TN$4774.11
TX$4707.28
UT$4587.52
VA$4887.05
VI$5707.20
VT$5131.74
WA$4794.05
WI$4869.75
WV$4887.05
WY$4587.52

KN Prosthetics & orthotics

Medicare allowable ranges from $1889.31 to $2403.03 depending on state and rural status.

Former-CBA payment limits: ceiling $2440.15 · floor $1830.11

StateNon-ruralRural
AK$2266.22
AL$2010.18
AR$1982.03
AZ$2114.84
CA$2114.84
CO$1931.56
CT$2160.74
DC$2057.68
DE$2057.68
FL$2010.18
GA$2010.18
HI$2169.76
IA$1889.31
ID$2018.53
IL$2050.41
IN$2050.41
KS$1889.31
KY$2010.18
LA$1982.03
MA$2160.74
MD$2057.68
ME$2160.74
MI$2050.41
MN$2050.41
MO$1889.31
MS$2010.18
MT$1931.56
NC$2010.18
ND$1931.56
NE$1889.31
NH$2160.74
NJ$2244.09
NM$1982.03
NV$2114.84
NY$2244.09
OH$2050.41
OK$1982.03
OR$2018.53
PA$2057.68
PR$1902.23
RI$2160.74
SC$2010.18
SD$1931.56
TN$2010.18
TX$1982.03
UT$1931.56
VA$2057.68
VI$2403.03
VT$2160.74
WA$2018.53
WI$2050.41
WV$2057.68
WY$1931.56
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

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