L8612 — Aqueous shunt
HCPCS Level II L-code · short descriptor: “Aqueous shunt prosthesis”
- 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.
L8612 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $744.39 to $974.58 depending on state and rural status.
Former-CBA payment limits: ceiling $992.51 · floor $744.39
| State | Non-rural | Rural |
|---|---|---|
| AL | $827.06 | — |
| AR | $784.75 | — |
| AZ | $973.96 | — |
| CA | $973.96 | — |
| CO | $823.49 | — |
| CT | $878.38 | — |
| DC | $756.41 | — |
| DE | $756.41 | — |
| FL | $827.06 | — |
| GA | $827.06 | — |
| IA | $744.39 | — |
| ID | $886.66 | — |
| IL | $974.58 | — |
| IN | $974.58 | — |
| KS | $744.39 | — |
| KY | $827.06 | — |
| LA | $784.75 | — |
| MA | $878.38 | — |
| MD | $756.41 | — |
| ME | $878.38 | — |
| MI | $974.58 | — |
| MN | $974.58 | — |
| MO | $744.39 | — |
| MS | $827.06 | — |
| MT | $823.49 | — |
| NC | $827.06 | — |
| ND | $823.49 | — |
| NE | $744.39 | — |
| NH | $878.38 | — |
| NJ | $810.60 | — |
| NM | $784.75 | — |
| NV | $973.96 | — |
| NY | $810.60 | — |
| OH | $974.58 | — |
| OK | $784.75 | — |
| OR | $886.66 | — |
| PA | $756.41 | — |
| RI | $878.38 | — |
| SC | $827.06 | — |
| SD | $823.49 | — |
| TN | $827.06 | — |
| TX | $784.75 | — |
| UT | $823.49 | — |
| VA | $756.41 | — |
| VT | $878.38 | — |
| WA | $886.66 | — |
| WI | $974.58 | — |
| WV | $756.41 | — |
| WY | $823.49 | — |
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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