MyMedi-AI

L8440 — Prosthetic shrinker, below knee, each

HCPCS Level II L-code · short descriptor: “Shrinker below knee”

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
4
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.

L8440 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $51.20 to $98.92 depending on state and rural status.

Former-CBA payment limits: ceiling $68.26 · floor $51.20

StateNon-ruralRural
AK$92.49—
AL$64.18—
AR$54.07—
AZ$68.26—
CA$68.26—
CO$51.20—
CT$57.58—
DC$51.20—
DE$51.20—
FL$64.18—
GA$64.18—
HI$98.92—
IA$51.33—
ID$51.20—
IL$57.40—
IN$57.40—
KS$51.33—
KY$64.18—
LA$54.07—
MA$57.58—
MD$51.20—
ME$57.58—
MI$57.40—
MN$57.40—
MO$51.33—
MS$64.18—
MT$51.20—
NC$64.18—
ND$51.20—
NE$51.33—
NH$57.58—
NJ$66.24—
NM$54.07—
NV$68.26—
NY$66.24—
OH$57.40—
OK$54.07—
OR$51.20—
PA$51.20—
PR$61.30—
RI$57.58—
SC$64.18—
SD$51.20—
TN$64.18—
TX$54.07—
UT$51.20—
VA$51.20—
VI$66.24—
VT$57.58—
WA$51.20—
WI$57.40—
WV$51.20—
WY$51.20—
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 L8440 at 4 units 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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