L8641 — Metatarsal joint 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.
L8641 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $428.55 to $571.40 depending on state and rural status.
Former-CBA payment limits: ceiling $571.40 · floor $428.55
| State | Non-rural | Rural |
|---|---|---|
| AL | $447.67 | — |
| AR | $428.55 | — |
| AZ | $433.44 | — |
| CA | $433.44 | — |
| CO | $571.40 | — |
| CT | $571.40 | — |
| DC | $428.55 | — |
| DE | $428.55 | — |
| FL | $447.67 | — |
| GA | $447.67 | — |
| IA | $428.55 | — |
| ID | $571.40 | — |
| IL | $428.55 | — |
| IN | $428.55 | — |
| KS | $428.55 | — |
| KY | $447.67 | — |
| LA | $428.55 | — |
| MA | $571.40 | — |
| MD | $428.55 | — |
| ME | $571.40 | — |
| MI | $428.55 | — |
| MN | $428.55 | — |
| MO | $428.55 | — |
| MS | $447.67 | — |
| MT | $571.40 | — |
| NC | $447.67 | — |
| ND | $571.40 | — |
| NE | $428.55 | — |
| NH | $571.40 | — |
| NJ | $428.55 | — |
| NM | $428.55 | — |
| NV | $433.44 | — |
| NY | $428.55 | — |
| OH | $428.55 | — |
| OK | $428.55 | — |
| OR | $571.40 | — |
| PA | $428.55 | — |
| RI | $571.40 | — |
| SC | $447.67 | — |
| SD | $571.40 | — |
| TN | $447.67 | — |
| TX | $428.55 | — |
| UT | $571.40 | — |
| VA | $428.55 | — |
| VT | $571.40 | — |
| WA | $571.40 | — |
| WI | $428.55 | — |
| WV | $428.55 | — |
| WY | $571.40 | — |
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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