L8485 HCPCS code: Prosthetic sock, single ply, fitting, upper limb, each
L8485 is the HCPCS Level II code for prosthetic sock, single ply, fitting, upper limb, each. The 2026 Medicare DMEPOS fee schedule pays $13.62 to $17.97 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. Its average fee ranks 3 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 | 1994-01-01 |
| Last action effective | 1999-01-01 |
2026 Medicare DMEPOS fee schedule for L8485
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $13.62 | $17.97 | $18.16 | $13.62 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $17.52 | — |
| AL | — | $13.62 | — |
| AR | — | $13.62 | — |
| AZ | — | $17.62 | — |
| CA | — | $17.62 | — |
| CO | — | $16.33 | — |
| CT | — | $14.31 | — |
| DC | — | $14.16 | — |
| DE | — | $14.16 | — |
| FL | — | $13.62 | — |
| GA | — | $13.62 | — |
| HI | — | $17.52 | — |
| IA | — | $17.97 | — |
| ID | — | $17.62 | — |
| IL | — | $15.17 | — |
| IN | — | $15.17 | — |
| KS | — | $17.97 | — |
| KY | — | $13.62 | — |
| LA | — | $13.62 | — |
| MA | — | $14.31 | — |
| MD | — | $14.16 | — |
| ME | — | $14.31 | — |
| MI | — | $15.17 | — |
| MN | — | $15.17 | — |
| MO | — | $17.97 | — |
| MS | — | $13.62 | — |
| MT | — | $16.33 | — |
| NC | — | $13.62 | — |
| ND | — | $16.33 | — |
| NE | — | $17.97 | — |
| NH | — | $14.31 | — |
| NJ | — | $13.67 | — |
| NM | — | $13.62 | — |
| NV | — | $17.62 | — |
| NY | — | $13.67 | — |
| OH | — | $15.17 | — |
| OK | — | $13.62 | — |
| OR | — | $17.62 | — |
| PA | — | $14.16 | — |
| PR | — | $16.78 | — |
| RI | — | $14.31 | — |
| SC | — | $13.62 | — |
| SD | — | $16.33 | — |
| TN | — | $13.62 | — |
| TX | — | $13.62 | — |
| UT | — | $16.33 | — |
| VA | — | $14.16 | — |
| VI | — | $13.67 | — |
| VT | — | $14.31 | — |
| WA | — | $17.62 | — |
| WI | — | $15.17 | — |
| WV | — | $14.16 | — |
| WY | — | $16.33 | — |
How the L8485 fee compares
| Measure | Value |
|---|---|
| Rank among 13 L84 codes (lowest = 1) | 3 |
| 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 | 12 | Clinical: Data |
| outpatient hospital claims | 12 | Clinical: CMS Workgroup |
What changed for L8485
- 2026-01-01: Average state fee rose 2.0%: $14.93 to $15.23
- 1994-01-01: L8485 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 L8485?
L8485 is the HCPCS Level II code for prosthetic sock, single ply, fitting, upper limb, each. Short descriptor: "Pros sock single ply upper l".
How much does Medicare pay for L8485?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $13.62–$17.97. Rural fees can be higher.
Does Medicare cover L8485?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L8485 change in 2026?
The average non-rural state fee moved from $14.93 in 2025 to $15.23 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8485 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)
- 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)
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Next steps
- Run a reimbursement report for a device billed under L8485
- Watch L8485 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8485
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.