L8600 — Implantable breast prosthesis, silicone or equal
HCPCS Level II L-code · short descriptor: “Implant breast silicone/eq”
- 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.
L8600 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $764.47 to $1019.30 depending on state and rural status.
Former-CBA payment limits: ceiling $1019.30 · floor $764.47
| State | Non-rural | Rural |
|---|---|---|
| AL | $764.47 | — |
| AR | $764.47 | — |
| AZ | $833.22 | — |
| CA | $833.22 | — |
| CO | $1019.30 | — |
| CT | $771.14 | — |
| DC | $766.26 | — |
| DE | $766.26 | — |
| FL | $764.47 | — |
| GA | $764.47 | — |
| IA | $764.47 | — |
| ID | $892.83 | — |
| IL | $1019.30 | — |
| IN | $1019.30 | — |
| KS | $764.47 | — |
| KY | $764.47 | — |
| LA | $764.47 | — |
| MA | $771.14 | — |
| MD | $766.26 | — |
| ME | $771.14 | — |
| MI | $1019.30 | — |
| MN | $1019.30 | — |
| MO | $764.47 | — |
| MS | $764.47 | — |
| MT | $1019.30 | — |
| NC | $764.47 | — |
| ND | $1019.30 | — |
| NE | $764.47 | — |
| NH | $771.14 | — |
| NJ | $764.47 | — |
| NM | $764.47 | — |
| NV | $833.22 | — |
| NY | $764.47 | — |
| OH | $1019.30 | — |
| OK | $764.47 | — |
| OR | $892.83 | — |
| PA | $766.26 | — |
| RI | $771.14 | — |
| SC | $764.47 | — |
| SD | $1019.30 | — |
| TN | $764.47 | — |
| TX | $764.47 | — |
| UT | $1019.30 | — |
| VA | $766.26 | — |
| VT | $771.14 | — |
| WA | $892.83 | — |
| WI | $1019.30 | — |
| WV | $766.26 | — |
| WY | $1019.30 | — |
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 L8600 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 →