L8609 HCPCS code: Artificial cornea
L8609 is the HCPCS Level II code for artificial cornea. The 2026 Medicare DMEPOS fee schedule pays $7,830.54 to $8,127.00 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 outpatient hospital claims. Its average fee ranks 39 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 | 2006-01-01 |
| Last action effective | 2006-01-01 |
2026 Medicare DMEPOS fee schedule for L8609
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $7,830.54 | $8,127.00 | $9,558.42 | $7,168.81 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AL | — | $8,066.32 | — |
| AR | — | $8,065.55 | — |
| AZ | — | $7,830.54 | — |
| CA | — | $7,830.54 | — |
| CO | — | $8,127.00 | — |
| CT | — | $7,830.54 | — |
| DC | — | $7,830.54 | — |
| DE | — | $7,830.54 | — |
| FL | — | $8,066.32 | — |
| GA | — | $8,066.32 | — |
| IA | — | $7,983.46 | — |
| ID | — | $7,830.54 | — |
| IL | — | $8,022.85 | — |
| IN | — | $8,022.85 | — |
| KS | — | $7,983.46 | — |
| KY | — | $8,066.32 | — |
| LA | — | $8,065.55 | — |
| MA | — | $7,830.54 | — |
| MD | — | $7,830.54 | — |
| ME | — | $7,830.54 | — |
| MI | — | $8,022.85 | — |
| MN | — | $8,022.85 | — |
| MO | — | $7,983.46 | — |
| MS | — | $8,066.32 | — |
| MT | — | $8,127.00 | — |
| NC | — | $8,066.32 | — |
| ND | — | $8,127.00 | — |
| NE | — | $7,983.46 | — |
| NH | — | $7,830.54 | — |
| NJ | — | $7,830.54 | — |
| NM | — | $8,065.55 | — |
| NV | — | $7,830.54 | — |
| NY | — | $7,830.54 | — |
| OH | — | $8,022.85 | — |
| OK | — | $8,065.55 | — |
| OR | — | $7,830.54 | — |
| PA | — | $7,830.54 | — |
| RI | — | $7,830.54 | — |
| SC | — | $8,066.32 | — |
| SD | — | $8,127.00 | — |
| TN | — | $8,066.32 | — |
| TX | — | $8,065.55 | — |
| UT | — | $8,127.00 | — |
| VA | — | $7,830.54 | — |
| VT | — | $7,830.54 | — |
| WA | — | $7,830.54 | — |
| WI | — | $8,022.85 | — |
| WV | — | $7,830.54 | — |
| WY | — | $8,127.00 | — |
How the L8609 fee compares
| Measure | Value |
|---|---|
| Rank among 43 L86 codes (lowest = 1) | 39 |
| Family fee range (average of state fees) | $0.40–$23,640.75 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
| practitioner claims | 1 | Clinical: Data |
What changed for L8609
- 2026-01-01: Average state fee rose 2.0%: $7,809.17 to $7,965.35
- 2006-01-01: L8609 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 L8609?
L8609 is the HCPCS Level II code for artificial cornea. Short descriptor: "Artificial cornea".
How much does Medicare pay for L8609?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $7,830.54–$8,127.00. Rural fees can be higher.
Does Medicare cover L8609?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L8609 change in 2026?
The average non-rural state fee moved from $7,809.17 in 2025 to $7,965.35 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8609 can be billed per day?
1 on outpatient hospital claims; 1 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
- 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
- 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)
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Next steps
- Run a reimbursement report for a device billed under L8609
- Watch L8609 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8609
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.