L8400 HCPCS code: Prosthetic sheath, below knee, each
L8400 is the HCPCS Level II code for prosthetic sheath, below knee, each. The 2026 Medicare DMEPOS fee schedule pays $19.27 to $31.34 depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 12 per day on DME suppliers. In 2024, 1,467 suppliers billed Medicare for L8400 (purchases), serving 8,554 beneficiaries; California, Texas, New York accounted for 24% of services. Its average fee ranks 4 of 13 L84 codes (family range $8.84–$92.93).
Code details
| Field | Value |
|---|---|
| Section | L codes — Orthotic and prosthetic procedures and devices |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1982-01-01 |
| Last action effective | 1996-01-01 |
2026 Medicare DMEPOS fee schedule for L8400
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $19.27 | $31.34 | $25.69 | $19.27 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $29.34 | — |
| AL | — | $23.21 | — |
| AR | — | $19.27 | — |
| AZ | — | $25.69 | — |
| CA | — | $25.69 | — |
| CO | — | $19.27 | — |
| CT | — | $21.93 | — |
| DC | — | $21.27 | — |
| DE | — | $21.27 | — |
| FL | — | $23.21 | — |
| GA | — | $23.21 | — |
| HI | — | $31.34 | — |
| IA | — | $22.42 | — |
| ID | — | $22.73 | — |
| IL | — | $19.27 | — |
| IN | — | $19.27 | — |
| KS | — | $22.42 | — |
| KY | — | $23.21 | — |
| LA | — | $19.27 | — |
| MA | — | $21.93 | — |
| MD | — | $21.27 | — |
| ME | — | $21.93 | — |
| MI | — | $19.27 | — |
| MN | — | $19.27 | — |
| MO | — | $22.42 | — |
| MS | — | $23.21 | — |
| MT | — | $19.27 | — |
| NC | — | $23.21 | — |
| ND | — | $19.27 | — |
| NE | — | $22.42 | — |
| NH | — | $21.93 | — |
| NJ | — | $25.69 | — |
| NM | — | $19.27 | — |
| NV | — | $25.69 | — |
| NY | — | $25.69 | — |
| OH | — | $19.27 | — |
| OK | — | $19.27 | — |
| OR | — | $22.73 | — |
| PA | — | $21.27 | — |
| PR | — | $30.64 | — |
| RI | — | $21.93 | — |
| SC | — | $23.21 | — |
| SD | — | $19.27 | — |
| TN | — | $23.21 | — |
| TX | — | $19.27 | — |
| UT | — | $19.27 | — |
| VA | — | $21.27 | — |
| VI | — | $25.69 | — |
| VT | — | $21.93 | — |
| WA | — | $22.73 | — |
| WI | — | $19.27 | — |
| WV | — | $21.27 | — |
| WY | — | $19.27 | — |
How the L8400 fee compares
| Measure | Value |
|---|---|
| Rank among 13 L84 codes (lowest = 1) | 4 |
| Family fee range (average of state fees) | $8.84–$92.93 |
| Rural fee uplift | — |
Who bills L8400 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 1,467 |
| Referring clinicians | 6,159 |
| Medicare beneficiaries | 8,554 |
| States with claims | 51 |
| Share of services in top 3 states (California, Texas, New York) | 24% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1,533 | 8,714 |
| 2023 | 1,526 | 8,849 |
| 2024 | 1,467 | 8,554 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8400, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 63,769 | 8,714 | $19.15 | $14.76 |
| 2023 | 64,431 | 8,849 | $20.70 | $15.85 |
| 2024 | 63,259 | 8,554 | $21.41 | $16.43 |
States with the most L8400 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 6,887 | $18.86 |
| Texas | 4,505 | $14.59 |
| New York | 3,639 | $18.79 |
| Florida | 3,089 | $17.18 |
| Pennsylvania | 2,665 | $15.90 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 12 | Clinical: Data |
| outpatient hospital claims | 12 | Clinical: Data |
Medicare policy articles for this code
- A52496: Lower Limb Prostheses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for L8400
- 2026-01-01: Average state fee rose 2.0%: $21.75 to $22.18
- 1982-01-01: L8400 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code L8400?
L8400 is the HCPCS Level II code for prosthetic sheath, below knee, each. Short descriptor: "Sheath below knee".
How much does Medicare pay for L8400?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $19.27–$31.34. Rural fees can be higher.
Does Medicare cover L8400?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L8400 change in 2026?
The average non-rural state fee moved from $21.75 in 2025 to $22.18 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8400 can be billed per day?
12 on DME suppliers; 12 on outpatient hospital claims (NCCI medically unlikely edits).
Related L84 codes
- L8410 — Prosthetic sheath, above knee, each ($25.36–$36.14)
- L8415 — Prosthetic sheath, upper limb, each ($26.24–$34.99)
- L8417 — Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each ($90.25–$99.43)
- L8420 — Prosthetic sock, multiple ply, below knee, each ($23.81–$47.61)
- L8430 — Prosthetic sock, multiple ply, above knee, each ($27.10–$47.61)
- L8435 — Prosthetic sock, multiple ply, upper limb, each ($25.74–$35.23)
- L8440 — Prosthetic shrinker, below knee, each ($51.20–$98.92)
- L8460 — Prosthetic shrinker, above knee, each ($81.59–$184.58)
- L8465 — Prosthetic shrinker, upper limb, each ($38.70–$79.62)
- L8470 — Prosthetic sock, single ply, fitting, below knee, each ($4.24–$12.04)
- L8480 — Prosthetic sock, single ply, fitting, above knee, each ($6.28–$15.03)
- L8485 — Prosthetic sock, single ply, fitting, upper limb, each ($13.62–$17.97)
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Next steps
- Run a reimbursement report for a device billed under L8400
- Watch L8400 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8400
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.