MyMedi-AI

L8606 — Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies

HCPCS Level II L-code · short descriptor: “Synthetic implnt urinary 1ml”

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
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.

L8606 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $252.88 to $281.84 depending on state and rural status.

Former-CBA payment limits: ceiling $322.77 · floor $242.08

StateNon-ruralRural
AL$281.84—
AR$269.39—
AZ$278.74—
CA$278.74—
CO$270.16—
CT$263.47—
DC$266.86—
DE$266.86—
FL$281.84—
GA$281.84—
IA$268.67—
ID$273.45—
IL$252.88—
IN$252.88—
KS$268.67—
KY$281.84—
LA$269.39—
MA$263.47—
MD$266.86—
ME$263.47—
MI$252.88—
MN$252.88—
MO$268.67—
MS$281.84—
MT$270.16—
NC$281.84—
ND$270.16—
NE$268.67—
NH$263.47—
NJ$263.29—
NM$269.39—
NV$278.74—
NY$263.29—
OH$252.88—
OK$269.39—
OR$273.45—
PA$266.86—
RI$263.47—
SC$281.84—
SD$270.16—
TN$281.84—
TX$269.39—
UT$270.16—
VA$266.86—
VT$263.47—
WA$273.45—
WI$252.88—
WV$266.86—
WY$270.16—
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.

Common denial codes to watch

Related L-codes

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