L8600 HCPCS code: Implantable breast prosthesis, silicone or equal
L8600 is the HCPCS Level II code for implantable breast prosthesis, silicone or equal. The 2026 Medicare DMEPOS fee schedule pays $764.47 to $1,019.30 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 2 per day on outpatient hospital claims. Medicare volume fell 26% from 2022 to 2024 (46 to 34 services). In 2024, about 8 clinicians billed Medicare for L8600 for 22 beneficiaries. Its average fee ranks 24 of 43 L86 codes (family range $0.40–$23,640.75).
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 | 1992-01-01 |
| Last action effective | 1997-10-01 |
2026 Medicare DMEPOS fee schedule for L8600
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $764.47 | $1,019.30 | $1,019.30 | $764.47 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AL | — | $764.47 | — |
| AR | — | $764.47 | — |
| AZ | — | $833.22 | — |
| CA | — | $833.22 | — |
| CO | — | $1,019.30 | — |
| CT | — | $771.14 | — |
| DC | — | $766.26 | — |
| DE | — | $766.26 | — |
| FL | — | $764.47 | — |
| GA | — | $764.47 | — |
| IA | — | $764.47 | — |
| ID | — | $892.83 | — |
| IL | — | $1,019.30 | — |
| IN | — | $1,019.30 | — |
| KS | — | $764.47 | — |
| KY | — | $764.47 | — |
| LA | — | $764.47 | — |
| MA | — | $771.14 | — |
| MD | — | $766.26 | — |
| ME | — | $771.14 | — |
| MI | — | $1,019.30 | — |
| MN | — | $1,019.30 | — |
| MO | — | $764.47 | — |
| MS | — | $764.47 | — |
| MT | — | $1,019.30 | — |
| NC | — | $764.47 | — |
| ND | — | $1,019.30 | — |
| NE | — | $764.47 | — |
| NH | — | $771.14 | — |
| NJ | — | $764.47 | — |
| NM | — | $764.47 | — |
| NV | — | $833.22 | — |
| NY | — | $764.47 | — |
| OH | — | $1,019.30 | — |
| OK | — | $764.47 | — |
| OR | — | $892.83 | — |
| PA | — | $766.26 | — |
| RI | — | $771.14 | — |
| SC | — | $764.47 | — |
| SD | — | $1,019.30 | — |
| TN | — | $764.47 | — |
| TX | — | $764.47 | — |
| UT | — | $1,019.30 | — |
| VA | — | $766.26 | — |
| VT | — | $771.14 | — |
| WA | — | $892.83 | — |
| WI | — | $1,019.30 | — |
| WV | — | $766.26 | — |
| WY | — | $1,019.30 | — |
How the L8600 fee compares
| Measure | Value |
|---|---|
| Rank among 43 L86 codes (lowest = 1) | 24 |
| Family fee range (average of state fees) | $0.40–$23,640.75 |
| Rural fee uplift | — |
Who bills L8600 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 8 |
| Medicare beneficiaries | 22 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8600, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 46 | 27 | $738.26 | $589.04 |
| 2023 | 46 | 27 | $792.44 | $631.38 |
| 2024 | 34 | 22 | $803.27 | $640.00 |
States with the most L8600 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 16 | $642.20 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: Data |
| practitioner claims | 2 | Anatomic Consideration |
What changed for L8600
- 2026-01-01: Average state fee rose 2.0%: $823.51 to $839.98
- 1992-01-01: L8600 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 L8600?
L8600 is the HCPCS Level II code for implantable breast prosthesis, silicone or equal. Short descriptor: "Implant breast silicone/eq".
How much does Medicare pay for L8600?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $764.47–$1,019.30. Rural fees can be higher.
Does Medicare cover L8600?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L8600 change in 2026?
The average non-rural state fee moved from $823.51 in 2025 to $839.98 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8600 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related L86 codes
- L8603 — Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies ($534.60–$539.27)
- L8604 — Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
- L8605 — Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies ($860.80–$946.86)
- L8606 — Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies ($252.88–$281.84)
- L8607 — Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies ($51.53–$56.69)
- L8608 — Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system
- L8609 — Artificial cornea ($7,830.54–$8,127.00)
- L8610 — Ocular implant ($716.57–$955.43)
- L8612 — Aqueous shunt ($744.39–$974.58)
- L8613 — Ossicula implant ($314.80–$418.46)
- L8614 — Cochlear device, includes all internal and external components ($22,998.52–$24,149.06)
- L8615 — Headset/headpiece for use with cochlear implant device, replacement ($542.05–$562.60)
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 L8600
- Watch L8600 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8600
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.