L8440 HCPCS code: Prosthetic shrinker, below knee, each
L8440 is the HCPCS Level II code for prosthetic shrinker, below knee, each. The 2026 Medicare DMEPOS fee schedule pays $51.20 to $98.92 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 4 per day on DME suppliers. Medicare volume fell 2% from 2022 to 2024 (29,516 to 28,853 services). In 2024, 1,930 suppliers billed Medicare for L8440 (purchases), serving 11,362 beneficiaries; Texas, California, Florida accounted for 25% of services. Its average fee ranks 10 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 L8440
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $51.20 | $98.92 | $68.26 | $51.20 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $92.49 | — |
| AL | — | $64.18 | — |
| AR | — | $54.07 | — |
| AZ | — | $68.26 | — |
| CA | — | $68.26 | — |
| CO | — | $51.20 | — |
| CT | — | $57.58 | — |
| DC | — | $51.20 | — |
| DE | — | $51.20 | — |
| FL | — | $64.18 | — |
| GA | — | $64.18 | — |
| HI | — | $98.92 | — |
| IA | — | $51.33 | — |
| ID | — | $51.20 | — |
| IL | — | $57.40 | — |
| IN | — | $57.40 | — |
| KS | — | $51.33 | — |
| KY | — | $64.18 | — |
| LA | — | $54.07 | — |
| MA | — | $57.58 | — |
| MD | — | $51.20 | — |
| ME | — | $57.58 | — |
| MI | — | $57.40 | — |
| MN | — | $57.40 | — |
| MO | — | $51.33 | — |
| MS | — | $64.18 | — |
| MT | — | $51.20 | — |
| NC | — | $64.18 | — |
| ND | — | $51.20 | — |
| NE | — | $51.33 | — |
| NH | — | $57.58 | — |
| NJ | — | $66.24 | — |
| NM | — | $54.07 | — |
| NV | — | $68.26 | — |
| NY | — | $66.24 | — |
| OH | — | $57.40 | — |
| OK | — | $54.07 | — |
| OR | — | $51.20 | — |
| PA | — | $51.20 | — |
| PR | — | $61.30 | — |
| RI | — | $57.58 | — |
| SC | — | $64.18 | — |
| SD | — | $51.20 | — |
| TN | — | $64.18 | — |
| TX | — | $54.07 | — |
| UT | — | $51.20 | — |
| VA | — | $51.20 | — |
| VI | — | $66.24 | — |
| VT | — | $57.58 | — |
| WA | — | $51.20 | — |
| WI | — | $57.40 | — |
| WV | — | $51.20 | — |
| WY | — | $51.20 | — |
How the L8440 fee compares
| Measure | Value |
|---|---|
| Rank among 13 L84 codes (lowest = 1) | 10 |
| Family fee range (average of state fees) | $8.84–$92.93 |
| Rural fee uplift | — |
Who bills L8440 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 1,930 |
| Referring clinicians | 7,826 |
| Medicare beneficiaries | 11,362 |
| States with claims | 52 |
| Share of services in top 3 states (Texas, California, Florida) | 25% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 2,026 | 11,794 |
| 2023 | 1,981 | 11,738 |
| 2024 | 1,930 | 11,362 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8440, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 29,516 | 11,794 | $50.52 | $38.98 |
| 2023 | 29,619 | 11,738 | $54.92 | $42.14 |
| 2024 | 28,853 | 11,362 | $56.61 | $43.39 |
States with the most L8440 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 3,305 | $40.53 |
| California | 2,459 | $50.29 |
| Florida | 1,481 | $47.63 |
| Pennsylvania | 1,468 | $38.09 |
| New York | 1,331 | $48.33 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 4 | Clinical: Data |
| outpatient hospital claims | 4 | 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 L8440
- 2026-01-01: Average state fee rose 2.0%: $57.40 to $58.55
- 1982-01-01: L8440 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 L8440?
L8440 is the HCPCS Level II code for prosthetic shrinker, below knee, each. Short descriptor: "Shrinker below knee".
How much does Medicare pay for L8440?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $51.20–$98.92. Rural fees can be higher.
Does Medicare cover L8440?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L8440 change in 2026?
The average non-rural state fee moved from $57.40 in 2025 to $58.55 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8440 can be billed per day?
4 on DME suppliers; 4 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)
- L8430 — Prosthetic sock, multiple ply, above knee, each ($27.10–$47.61)
- L8435 — Prosthetic sock, multiple ply, upper limb, each ($25.74–$35.23)
- 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)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under L8440
- Watch L8440 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8440
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.