L8430 HCPCS code: Prosthetic sock, multiple ply, above knee, each
L8430 is the HCPCS Level II code for prosthetic sock, multiple ply, above knee, each. The 2026 Medicare DMEPOS fee schedule pays $27.10 to $47.61 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 24 per day on DME suppliers. Its average fee ranks 9 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 | 1999-01-01 |
2026 Medicare DMEPOS fee schedule for L8430
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $27.10 | $47.61 | $36.14 | $27.10 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $34.81 | — |
| AL | — | $33.75 | — |
| AR | — | $27.95 | — |
| AZ | — | $34.09 | — |
| CA | — | $34.09 | — |
| CO | — | $30.07 | — |
| CT | — | $29.80 | — |
| DC | — | $27.10 | — |
| DE | — | $27.10 | — |
| FL | — | $33.75 | — |
| GA | — | $33.75 | — |
| HI | — | $37.26 | — |
| IA | — | $29.92 | — |
| ID | — | $28.04 | — |
| IL | — | $29.09 | — |
| IN | — | $29.09 | — |
| KS | — | $29.92 | — |
| KY | — | $33.75 | — |
| LA | — | $27.95 | — |
| MA | — | $29.80 | — |
| MD | — | $27.10 | — |
| ME | — | $29.80 | — |
| MI | — | $29.09 | — |
| MN | — | $29.09 | — |
| MO | — | $29.92 | — |
| MS | — | $33.75 | — |
| MT | — | $30.07 | — |
| NC | — | $33.75 | — |
| ND | — | $30.07 | — |
| NE | — | $29.92 | — |
| NH | — | $29.80 | — |
| NJ | — | $31.88 | — |
| NM | — | $27.95 | — |
| NV | — | $34.09 | — |
| NY | — | $31.88 | — |
| OH | — | $29.09 | — |
| OK | — | $27.95 | — |
| OR | — | $28.04 | — |
| PA | — | $27.10 | — |
| PR | — | $47.61 | — |
| RI | — | $29.80 | — |
| SC | — | $33.75 | — |
| SD | — | $30.07 | — |
| TN | — | $33.75 | — |
| TX | — | $27.95 | — |
| UT | — | $30.07 | — |
| VA | — | $27.10 | — |
| VI | — | $31.89 | — |
| VT | — | $29.80 | — |
| WA | — | $28.04 | — |
| WI | — | $29.09 | — |
| WV | — | $27.10 | — |
| WY | — | $30.07 | — |
How the L8430 fee compares
| Measure | Value |
|---|---|
| Rank among 13 L84 codes (lowest = 1) | 9 |
| Family fee range (average of state fees) | $8.84–$92.93 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 24 | Clinical: Data |
| outpatient hospital claims | 12 | Clinical: Data |
What changed for L8430
- 2026-01-01: Average state fee rose 2.0%: $30.11 to $30.71
- 1982-01-01: L8430 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 L8430?
L8430 is the HCPCS Level II code for prosthetic sock, multiple ply, above knee, each. Short descriptor: "Prosthetic sock multi ply ak".
How much does Medicare pay for L8430?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $27.10–$47.61. Rural fees can be higher.
Does Medicare cover L8430?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L8430 change in 2026?
The average non-rural state fee moved from $30.11 in 2025 to $30.71 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8430 can be billed per day?
24 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)
- 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)
- 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 L8430
- Watch L8430 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8430
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.