MyMedi-AI

L8500 — Artificial larynx, any type

HCPCS Level II L-code · short descriptor: “Artificial larynx”

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 2026-10-26; 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.

L8500 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $704.63 to $1077.27 depending on state and rural status.

Former-CBA payment limits: ceiling $1077.27 · floor $807.95

StateNon-ruralRural
AK$704.63—
AL$807.95—
AR$951.76—
AZ$807.95—
CA$807.95—
CO$807.95—
CT$909.66—
DC$1077.27—
DE$1077.27—
FL$807.95—
GA$807.95—
HI$753.43—
IA$918.74—
ID$955.76—
IL$810.32—
IN$810.32—
KS$918.74—
KY$807.95—
LA$951.76—
MA$909.66—
MD$1077.27—
ME$909.66—
MI$810.32—
MN$810.32—
MO$918.74—
MS$807.95—
MT$807.95—
NC$807.95—
ND$807.95—
NE$918.74—
NH$909.66—
NJ$930.40—
NM$951.76—
NV$807.95—
NY$930.40—
OH$810.32—
OK$951.76—
OR$955.76—
PA$1077.27—
PR$856.60—
RI$909.66—
SC$807.95—
SD$807.95—
TN$807.95—
TX$951.76—
UT$807.95—
VA$1077.27—
VI$930.37—
VT$909.66—
WA$955.76—
WI$810.32—
WV$1077.27—
WY$807.95—
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 L8500 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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