L8630 — Metacarpophalangeal joint implant
HCPCS Level II L-code · short descriptor: “Metacarpophalangeal implant”
- 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.
L8630 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $412.46 to $549.94 depending on state and rural status.
Former-CBA payment limits: ceiling $549.94 · floor $412.46
| State | Non-rural | Rural |
|---|---|---|
| AL | $412.46 | — |
| AR | $412.46 | — |
| AZ | $412.46 | — |
| CA | $412.46 | — |
| CO | $542.20 | — |
| CT | $549.94 | — |
| DC | $412.46 | — |
| DE | $412.46 | — |
| FL | $412.46 | — |
| GA | $412.46 | — |
| IA | $412.46 | — |
| ID | $412.46 | — |
| IL | $549.94 | — |
| IN | $549.94 | — |
| KS | $412.46 | — |
| KY | $412.46 | — |
| LA | $412.46 | — |
| MA | $549.94 | — |
| MD | $412.46 | — |
| ME | $549.94 | — |
| MI | $549.94 | — |
| MN | $549.94 | — |
| MO | $412.46 | — |
| MS | $412.46 | — |
| MT | $542.20 | — |
| NC | $412.46 | — |
| ND | $542.20 | — |
| NE | $412.46 | — |
| NH | $549.94 | — |
| NJ | $412.46 | — |
| NM | $412.46 | — |
| NV | $412.46 | — |
| NY | $412.46 | — |
| OH | $549.94 | — |
| OK | $412.46 | — |
| OR | $412.46 | — |
| PA | $412.46 | — |
| RI | $549.94 | — |
| SC | $412.46 | — |
| SD | $542.20 | — |
| TN | $412.46 | — |
| TX | $412.46 | — |
| UT | $542.20 | — |
| VA | $412.46 | — |
| VT | $549.94 | — |
| WA | $412.46 | — |
| WI | $549.94 | — |
| WV | $412.46 | — |
| WY | $542.20 | — |
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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