L8605 HCPCS code: Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies
L8605 is the HCPCS Level II code for injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies. The 2026 Medicare DMEPOS fee schedule pays $860.80 to $946.86 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 4 per day on outpatient hospital claims. Medicare volume rose 126% from 2022 to 2024 (214 to 483 services). In 2024, about 43 clinicians billed Medicare for L8605 for 107 beneficiaries. Its average fee ranks 26 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 | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2013-01-01 |
| Last action effective | 2013-01-01 |
2026 Medicare DMEPOS fee schedule for L8605
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $860.80 | $946.86 | $1,050.74 | $788.06 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $860.80 | — |
| AL | — | $886.74 | — |
| AR | — | $886.61 | — |
| AZ | — | $860.80 | — |
| CA | — | $860.80 | — |
| CO | — | $893.39 | — |
| CT | — | $860.80 | — |
| DC | — | $860.80 | — |
| DE | — | $860.80 | — |
| FL | — | $886.74 | — |
| GA | — | $886.74 | — |
| HI | — | $860.80 | — |
| IA | — | $877.59 | — |
| ID | — | $860.80 | — |
| IL | — | $881.94 | — |
| IN | — | $881.94 | — |
| KS | — | $877.59 | — |
| KY | — | $886.74 | — |
| LA | — | $886.61 | — |
| MA | — | $860.80 | — |
| MD | — | $860.80 | — |
| ME | — | $860.80 | — |
| MI | — | $881.94 | — |
| MN | — | $881.94 | — |
| MO | — | $877.59 | — |
| MS | — | $886.74 | — |
| MT | — | $893.39 | — |
| NC | — | $886.74 | — |
| ND | — | $893.39 | — |
| NE | — | $877.59 | — |
| NH | — | $860.80 | — |
| NJ | — | $860.80 | — |
| NM | — | $886.61 | — |
| NV | — | $860.80 | — |
| NY | — | $860.80 | — |
| OH | — | $881.94 | — |
| OK | — | $886.61 | — |
| OR | — | $860.80 | — |
| PA | — | $860.80 | — |
| PR | — | $946.86 | — |
| RI | — | $860.80 | — |
| SC | — | $886.74 | — |
| SD | — | $893.39 | — |
| TN | — | $886.74 | — |
| TX | — | $886.61 | — |
| UT | — | $893.39 | — |
| VA | — | $860.80 | — |
| VI | — | $946.86 | — |
| VT | — | $860.80 | — |
| WA | — | $860.80 | — |
| WI | — | $881.94 | — |
| WV | — | $860.80 | — |
| WY | — | $893.39 | — |
How the L8605 fee compares
| Measure | Value |
|---|---|
| Rank among 43 L86 codes (lowest = 1) | 26 |
| Family fee range (average of state fees) | $0.40–$23,640.75 |
| Rural fee uplift | — |
Who bills L8605 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 43 |
| Medicare beneficiaries | 107 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8605, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 214 | 58 | $729.32 | $581.90 |
| 2023 | 165 | 41 | $802.04 | $638.59 |
| 2024 | 483 | 107 | $821.51 | $653.79 |
States with the most L8605 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 185 | $659.31 |
| California | 126 | $646.12 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | Prescribing Information |
| practitioner claims | 4 | Prescribing Information |
What changed for L8605
- 2026-01-01: Average state fee rose 2.0%: $860.54 to $877.75
- 2013-01-01: L8605 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 L8605?
L8605 is the HCPCS Level II code for injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies. Short descriptor: "Inj bulking agent anal canal".
How much does Medicare pay for L8605?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $860.80–$946.86. Rural fees can be higher.
Does Medicare cover L8605?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L8605 change in 2026?
The average non-rural state fee moved from $860.54 in 2025 to $877.75 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8605 can be billed per day?
4 on outpatient hospital claims; 4 on practitioner claims (NCCI medically unlikely edits).
Related L86 codes
- L8600 — Implantable breast prosthesis, silicone or equal ($764.47–$1,019.30)
- 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
- 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 L8605
- Watch L8605 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8605
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.