L8417 HCPCS code: Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each
L8417 is the HCPCS Level II code for prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each. The 2026 Medicare DMEPOS fee schedule pays $90.25 to $99.43 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 12 per day on DME suppliers. Medicare volume fell 18% from 2022 to 2024 (6,635 to 5,459 services). In 2024, 525 suppliers billed Medicare for L8417 (purchases), serving 1,111 beneficiaries; California, Ohio, Texas accounted for 28% of services. Its average fee ranks 12 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 | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1997-01-01 |
| Last action effective | 1997-01-01 |
2026 Medicare DMEPOS fee schedule for L8417
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $90.25 | $99.43 | $110.26 | $82.70 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $91.26 | — |
| AL | — | $93.10 | — |
| AR | — | $93.09 | — |
| AZ | — | $90.39 | — |
| CA | — | $90.39 | — |
| CO | — | $93.60 | — |
| CT | — | $90.25 | — |
| DC | — | $90.32 | — |
| DE | — | $90.32 | — |
| FL | — | $93.10 | — |
| GA | — | $93.10 | — |
| HI | — | $97.62 | — |
| IA | — | $92.15 | — |
| ID | — | $90.39 | — |
| IL | — | $92.62 | — |
| IN | — | $92.62 | — |
| KS | — | $92.15 | — |
| KY | — | $93.10 | — |
| LA | — | $93.09 | — |
| MA | — | $90.25 | — |
| MD | — | $90.32 | — |
| ME | — | $90.25 | — |
| MI | — | $92.62 | — |
| MN | — | $92.62 | — |
| MO | — | $92.15 | — |
| MS | — | $93.10 | — |
| MT | — | $93.60 | — |
| NC | — | $93.10 | — |
| ND | — | $93.60 | — |
| NE | — | $92.15 | — |
| NH | — | $90.25 | — |
| NJ | — | $90.25 | — |
| NM | — | $93.09 | — |
| NV | — | $90.39 | — |
| NY | — | $90.25 | — |
| OH | — | $92.62 | — |
| OK | — | $93.09 | — |
| OR | — | $90.39 | — |
| PA | — | $90.32 | — |
| PR | — | $99.43 | — |
| RI | — | $90.25 | — |
| SC | — | $93.10 | — |
| SD | — | $93.60 | — |
| TN | — | $93.10 | — |
| TX | — | $93.09 | — |
| UT | — | $93.60 | — |
| VA | — | $90.32 | — |
| VI | — | $99.43 | — |
| VT | — | $90.25 | — |
| WA | — | $90.39 | — |
| WI | — | $92.62 | — |
| WV | — | $90.32 | — |
| WY | — | $93.60 | — |
How the L8417 fee compares
| Measure | Value |
|---|---|
| Rank among 13 L84 codes (lowest = 1) | 12 |
| Family fee range (average of state fees) | $8.84–$92.93 |
| Rural fee uplift | — |
Who bills L8417 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 525 |
| Referring clinicians | 994 |
| Medicare beneficiaries | 1,111 |
| States with claims | 34 |
| Share of services in top 3 states (California, Ohio, Texas) | 28% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 618 | 1,294 |
| 2023 | 568 | 1,180 |
| 2024 | 525 | 1,111 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8417, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,635 | 1,294 | $78.34 | $60.10 |
| 2023 | 6,249 | 1,180 | $84.10 | $64.39 |
| 2024 | 5,459 | 1,111 | $87.84 | $67.35 |
States with the most L8417 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 583 | $66.83 |
| Ohio | 464 | $67.43 |
| Texas | 421 | $68.81 |
| Georgia | 375 | $68.05 |
| New York | 371 | $67.34 |
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 L8417
- 2026-01-01: Average state fee rose 2.0%: $90.46 to $92.27
- 1997-01-01: L8417 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 L8417?
L8417 is the HCPCS Level II code for prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each. Short descriptor: "Pros sheath/sock w gel cushn".
How much does Medicare pay for L8417?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $90.25–$99.43. Rural fees can be higher.
Does Medicare cover L8417?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L8417 change in 2026?
The average non-rural state fee moved from $90.46 in 2025 to $92.27 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8417 can be billed per day?
12 on DME suppliers; 12 on outpatient hospital claims (NCCI medically unlikely edits).
Related L84 codes
- L8400 — Prosthetic sheath, below knee, each ($19.27–$31.34)
- L8410 — Prosthetic sheath, above knee, each ($25.36–$36.14)
- L8415 — Prosthetic sheath, upper limb, each ($26.24–$34.99)
- 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 L8417
- Watch L8417 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8417
Sources: CMS HCPCS Level II release October 2026; 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.