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L8610 — Ocular implant

HCPCS Level II L-code

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.

L8610 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $716.57 to $955.43 depending on state and rural status.

Former-CBA payment limits: ceiling $955.43 · floor $716.57

StateNon-ruralRural
AL$784.19
AR$812.14
AZ$716.57
CA$716.57
CO$955.43
CT$716.57
DC$720.25
DE$720.25
FL$784.19
GA$784.19
IA$716.57
ID$812.14
IL$837.02
IN$837.02
KS$716.57
KY$784.19
LA$812.14
MA$716.57
MD$720.25
ME$716.57
MI$837.02
MN$837.02
MO$716.57
MS$784.19
MT$955.43
NC$784.19
ND$955.43
NE$716.57
NH$716.57
NJ$848.70
NM$812.14
NV$716.57
NY$848.70
OH$837.02
OK$812.14
OR$812.14
PA$720.25
RI$716.57
SC$784.19
SD$955.43
TN$784.19
TX$812.14
UT$955.43
VA$720.25
VT$716.57
WA$812.14
WI$837.02
WV$720.25
WY$955.43
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

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