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L8046 — Partial facial prosthesis, provided by a non-physician

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

L8046 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $3047.25 to $3875.84 depending on state and rural status.

Former-CBA payment limits: ceiling $3935.73 · floor $2951.79

StateNon-ruralRural
AK$3655.23
AL$3242.18
AR$3196.79
AZ$3411.08
CA$3411.08
CO$3115.45
CT$3485.04
DC$3318.85
DE$3318.85
FL$3242.18
GA$3242.18
HI$3499.64
IA$3047.25
ID$3255.69
IL$3307.18
IN$3307.18
KS$3047.25
KY$3242.18
LA$3196.79
MA$3485.04
MD$3318.85
ME$3485.04
MI$3307.18
MN$3307.18
MO$3047.25
MS$3242.18
MT$3115.45
NC$3242.18
ND$3115.45
NE$3047.25
NH$3485.04
NJ$3619.49
NM$3196.79
NV$3411.08
NY$3619.49
OH$3307.18
OK$3196.79
OR$3255.69
PA$3318.85
PR$3068.13
RI$3485.04
SC$3242.18
SD$3115.45
TN$3242.18
TX$3196.79
UT$3115.45
VA$3318.85
VI$3875.84
VT$3485.04
WA$3255.69
WI$3307.18
WV$3318.85
WY$3115.45

KM Prosthetics & orthotics

Medicare allowable ranges from $2894.89 to $3682.03 depending on state and rural status.

Former-CBA payment limits: ceiling $3738.95 · floor $2804.21

StateNon-ruralRural
AK$3472.47
AL$3080.06
AR$3036.94
AZ$3240.50
CA$3240.50
CO$2959.70
CT$3310.82
DC$3152.94
DE$3152.94
FL$3080.06
GA$3080.06
HI$3324.65
IA$2894.89
ID$3092.92
IL$3141.80
IN$3141.80
KS$2894.89
KY$3080.06
LA$3036.94
MA$3310.82
MD$3152.94
ME$3310.82
MI$3141.80
MN$3141.80
MO$2894.89
MS$3080.06
MT$2959.70
NC$3080.06
ND$2959.70
NE$2894.89
NH$3310.82
NJ$3438.55
NM$3036.94
NV$3240.50
NY$3438.55
OH$3141.80
OK$3036.94
OR$3092.92
PA$3152.94
PR$2914.72
RI$3310.82
SC$3080.06
SD$2959.70
TN$3080.06
TX$3036.94
UT$2959.70
VA$3152.94
VI$3682.03
VT$3310.82
WA$3092.92
WI$3141.80
WV$3152.94
WY$2959.70

KN Prosthetics & orthotics

Medicare allowable ranges from $1218.90 to $1550.34 depending on state and rural status.

Former-CBA payment limits: ceiling $1574.28 · floor $1180.71

StateNon-ruralRural
AK$1462.10
AL$1296.84
AR$1278.71
AZ$1364.39
CA$1364.39
CO$1246.15
CT$1394.05
DC$1327.53
DE$1327.53
FL$1296.84
GA$1296.84
HI$1399.85
IA$1218.90
ID$1302.23
IL$1322.89
IN$1322.89
KS$1218.90
KY$1296.84
LA$1278.71
MA$1394.05
MD$1327.53
ME$1394.05
MI$1322.89
MN$1322.89
MO$1218.90
MS$1296.84
MT$1246.15
NC$1296.84
ND$1246.15
NE$1218.90
NH$1394.05
NJ$1447.81
NM$1278.71
NV$1364.39
NY$1447.81
OH$1322.89
OK$1278.71
OR$1302.23
PA$1327.53
PR$1227.26
RI$1394.05
SC$1296.84
SD$1246.15
TN$1296.84
TX$1278.71
UT$1246.15
VA$1327.53
VI$1550.34
VT$1394.05
WA$1302.23
WI$1322.89
WV$1327.53
WY$1246.15
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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