L8514 HCPCS code: Tracheoesophageal puncture dilator, replacement only, each
L8514 is the HCPCS Level II code for tracheoesophageal puncture dilator, replacement only, each. The 2026 Medicare DMEPOS fee schedule pays $113.31 to $136.01 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 1 per day on DME suppliers. Medicare volume rose 15% from 2022 to 2024 (20 to 23 services). In 2024, 2 suppliers billed Medicare for L8514 (purchases), serving 19 beneficiaries. Its average fee ranks 6 of 10 L85 codes (family range $2.66–$885.39).
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 | 2004-01-01 |
| Last action effective | 2004-01-01 |
2026 Medicare DMEPOS fee schedule for L8514
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $113.31 | $136.01 | $138.30 | $103.72 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $113.31 | — |
| AL | — | $116.74 | — |
| AR | — | $116.73 | — |
| AZ | — | $113.31 | — |
| CA | — | $113.31 | — |
| CO | — | $117.39 | — |
| CT | — | $113.31 | — |
| DC | — | $113.31 | — |
| DE | — | $113.31 | — |
| FL | — | $116.74 | — |
| GA | — | $116.74 | — |
| HI | — | $113.31 | — |
| IA | — | $115.56 | — |
| ID | — | $113.31 | — |
| IL | — | $116.13 | — |
| IN | — | $116.13 | — |
| KS | — | $115.56 | — |
| KY | — | $116.74 | — |
| LA | — | $116.73 | — |
| MA | — | $113.31 | — |
| MD | — | $113.31 | — |
| ME | — | $113.31 | — |
| MI | — | $116.13 | — |
| MN | — | $116.13 | — |
| MO | — | $115.56 | — |
| MS | — | $116.74 | — |
| MT | — | $117.39 | — |
| NC | — | $116.74 | — |
| ND | — | $117.39 | — |
| NE | — | $115.56 | — |
| NH | — | $113.31 | — |
| NJ | — | $113.31 | — |
| NM | — | $116.73 | — |
| NV | — | $113.31 | — |
| NY | — | $113.31 | — |
| OH | — | $116.13 | — |
| OK | — | $116.73 | — |
| OR | — | $113.31 | — |
| PA | — | $113.31 | — |
| PR | — | $136.01 | — |
| RI | — | $113.31 | — |
| SC | — | $116.74 | — |
| SD | — | $117.39 | — |
| TN | — | $116.74 | — |
| TX | — | $116.73 | — |
| UT | — | $117.39 | — |
| VA | — | $113.31 | — |
| VI | — | $136.01 | — |
| VT | — | $113.31 | — |
| WA | — | $113.31 | — |
| WI | — | $116.13 | — |
| WV | — | $113.31 | — |
| WY | — | $117.39 | — |
How the L8514 fee compares
| Measure | Value |
|---|---|
| Rank among 10 L85 codes (lowest = 1) | 6 |
| Family fee range (average of state fees) | $2.66–$885.39 |
| Rural fee uplift | — |
Who bills L8514 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 2 |
| Referring clinicians | 16 |
| Medicare beneficiaries | 19 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 2 | 16 |
| 2023 | 3 | 21 |
| 2024 | 2 | 19 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8514, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 20 | 16 | $95.37 | $75.26 |
| 2023 | 22 | 21 | $104.62 | $74.87 |
| 2024 | 23 | 19 | $108.37 | $77.58 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Clinical: Data |
| outpatient hospital claims | 1 | Clinical: Data |
| practitioner claims | 1 | Clinical: Data |
What changed for L8514
- 2026-01-01: Average state fee rose 2.0%: $113.68 to $115.96
- 2004-01-01: L8514 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 L8514?
L8514 is the HCPCS Level II code for tracheoesophageal puncture dilator, replacement only, each. Short descriptor: "Repl trach puncture dilator".
How much does Medicare pay for L8514?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $113.31–$136.01. Rural fees can be higher.
Does Medicare cover L8514?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L8514 change in 2026?
The average non-rural state fee moved from $113.68 in 2025 to $115.96 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8514 can be billed per day?
1 on DME suppliers; 1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related L85 codes
- L8500 — Artificial larynx, any type ($704.63–$1,077.27)
- L8501 — Tracheostomy speaking valve ($107.37–$197.18)
- L8505 — Artificial larynx replacement battery / accessory, any type
- L8507 — Tracheo-esophageal voice prosthesis, patient inserted, any type, each ($50.34–$55.40)
- L8509 — Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type ($131.24–$144.37)
- L8510 — Voice amplifier ($303.69–$334.05)
- L8511 — Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each ($87.41–$104.86)
- L8512 — Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10 ($2.59–$3.12)
- L8513 — Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each ($6.24–$7.46)
- L8515 — Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each ($75.84–$83.45)
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 L8514
- Watch L8514 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8514
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.