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
- 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 2026-10-26; 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 2026-10-26; 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.
L8044 Medicare fee schedule (October 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
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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
| State | Non-rural | Rural |
|---|---|---|
| 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 | — |
Unit limit (MUE)
Medicare's Medically Unlikely Edit caps L8044 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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