L8465 — Prosthetic shrinker, upper limb, each
HCPCS Level II L-code · short descriptor: “Shrinker upper limb”
- 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
- 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.
L8465 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $38.70 to $79.62 depending on state and rural status.
Former-CBA payment limits: ceiling $79.62 · floor $59.71
| State | Non-rural | Rural |
|---|---|---|
| AK | $52.40 | — |
| AL | $79.62 | — |
| AR | $67.04 | — |
| AZ | $59.71 | — |
| CA | $59.71 | — |
| CO | $59.71 | — |
| CT | $62.74 | — |
| DC | $72.23 | — |
| DE | $72.23 | — |
| FL | $79.62 | — |
| GA | $79.62 | — |
| HI | $56.07 | — |
| IA | $59.71 | — |
| ID | $59.71 | — |
| IL | $75.41 | — |
| IN | $75.41 | — |
| KS | $59.71 | — |
| KY | $79.62 | — |
| LA | $67.04 | — |
| MA | $62.74 | — |
| MD | $72.23 | — |
| ME | $62.74 | — |
| MI | $75.41 | — |
| MN | $75.41 | — |
| MO | $59.71 | — |
| MS | $79.62 | — |
| MT | $59.71 | — |
| NC | $79.62 | — |
| ND | $59.71 | — |
| NE | $59.71 | — |
| NH | $62.74 | — |
| NJ | $59.71 | — |
| NM | $67.04 | — |
| NV | $59.71 | — |
| NY | $59.71 | — |
| OH | $75.41 | — |
| OK | $67.04 | — |
| OR | $59.71 | — |
| PA | $72.23 | — |
| PR | $38.70 | — |
| RI | $62.74 | — |
| SC | $79.62 | — |
| SD | $59.71 | — |
| TN | $79.62 | — |
| TX | $67.04 | — |
| UT | $59.71 | — |
| VA | $72.23 | — |
| VI | $59.71 | — |
| VT | $62.74 | — |
| WA | $59.71 | — |
| WI | $75.41 | — |
| WV | $72.23 | — |
| WY | $59.71 | — |
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
Related L-codes
Bill L8465 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →