MyMedi-AI

L8310 — Truss, double with standard pads

HCPCS Level II L-code · short descriptor: “Truss double w/ standard pad”

Code system
HCPCS Level II
Family
L — Orthotics & prosthetics
Medicare coverage status
Special coverage instructions apply
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 2026-10-25; 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 2026-10-25; 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.

L8310 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $163.05 to $280.56 depending on state and rural status.

Former-CBA payment limits: ceiling $217.40 · floor $163.05

StateNon-ruralRural
AK$262.37—
AL$183.33—
AR$163.05—
AZ$217.40—
CA$217.40—
CO$190.05—
CT$163.05—
DC$163.05—
DE$163.05—
FL$183.33—
GA$183.33—
HI$280.56—
IA$208.52—
ID$179.71—
IL$182.95—
IN$182.95—
KS$208.52—
KY$183.33—
LA$163.05—
MA$163.05—
MD$163.05—
ME$163.05—
MI$182.95—
MN$182.95—
MO$208.52—
MS$183.33—
MT$190.05—
NC$183.33—
ND$190.05—
NE$208.52—
NH$163.05—
NJ$216.21—
NM$163.05—
NV$217.40—
NY$216.21—
OH$182.95—
OK$163.05—
OR$179.71—
PA$163.05—
PR$265.71—
RI$163.05—
SC$183.33—
SD$190.05—
TN$183.33—
TX$163.05—
UT$190.05—
VA$163.05—
VI$216.21—
VT$163.05—
WA$179.71—
WI$182.95—
WV$163.05—
WY$190.05—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L8310 at 1 unit per date of service (clinical). Units above the MUE deny — typically as CO-151. Rationale: Clinical: Data.

Common denial codes to watch

Related L-codes

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