L8616 HCPCS code: Microphone for use with cochlear implant device, replacement
L8616 is the HCPCS Level II code for microphone for use with cochlear implant device, replacement. The 2026 Medicare DMEPOS fee schedule pays $126.26 to $131.00 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 11% from 2022 to 2024 (1,051 to 933 services). In 2024, about 1 clinicians billed Medicare for L8616 for 824 beneficiaries. Its average fee ranks 9 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 | 2005-01-01 |
| Last action effective | 2005-01-01 |
2026 Medicare DMEPOS fee schedule for L8616
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $126.26 | $131.00 | $154.11 | $115.58 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AL | — | $130.06 | — |
| AR | — | $130.05 | — |
| AZ | — | $126.26 | — |
| CA | — | $126.26 | — |
| CO | — | $131.00 | — |
| CT | — | $126.26 | — |
| DC | — | $126.26 | — |
| DE | — | $126.26 | — |
| FL | — | $130.06 | — |
| GA | — | $130.06 | — |
| IA | — | $128.72 | — |
| ID | — | $126.26 | — |
| IL | — | $129.34 | — |
| IN | — | $129.34 | — |
| KS | — | $128.72 | — |
| KY | — | $130.06 | — |
| LA | — | $130.05 | — |
| MA | — | $126.26 | — |
| MD | — | $126.26 | — |
| ME | — | $126.26 | — |
| MI | — | $129.34 | — |
| MN | — | $129.34 | — |
| MO | — | $128.72 | — |
| MS | — | $130.06 | — |
| MT | — | $131.00 | — |
| NC | — | $130.06 | — |
| ND | — | $131.00 | — |
| NE | — | $128.72 | — |
| NH | — | $126.26 | — |
| NJ | — | $126.26 | — |
| NM | — | $130.05 | — |
| NV | — | $126.26 | — |
| NY | — | $126.26 | — |
| OH | — | $129.34 | — |
| OK | — | $130.05 | — |
| OR | — | $126.26 | — |
| PA | — | $126.26 | — |
| RI | — | $126.26 | — |
| SC | — | $130.06 | — |
| SD | — | $131.00 | — |
| TN | — | $130.06 | — |
| TX | — | $130.05 | — |
| UT | — | $131.00 | — |
| VA | — | $126.26 | — |
| VT | — | $126.26 | — |
| WA | — | $126.26 | — |
| WI | — | $129.34 | — |
| WV | — | $126.26 | — |
| WY | — | $131.00 | — |
How the L8616 fee compares
| Measure | Value |
|---|---|
| Rank among 43 L86 codes (lowest = 1) | 9 |
| Family fee range (average of state fees) | $0.40–$23,640.75 |
| Rural fee uplift | — |
Who bills L8616 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1 |
| Medicare beneficiaries | 824 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8616, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,051 | 915 | $107.82 | $84.41 |
| 2023 | 871 | 763 | $116.97 | $90.82 |
| 2024 | 933 | 824 | $120.78 | $94.75 |
States with the most L8616 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 933 | $94.75 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Nature of Equipment |
| practitioner claims | 2 | Nature of Equipment |
Medicare policy articles for this code
- A53708: Billing and Coding: External Components for Cochlear Implants (Palmetto GBA (MAC - Part B))
What changed for L8616
- 2026-01-01: Average state fee rose 2.0%: $125.91 to $128.43
- 2005-01-01: L8616 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 L8616?
L8616 is the HCPCS Level II code for microphone for use with cochlear implant device, replacement. Short descriptor: "Coch implant microphone repl".
How much does Medicare pay for L8616?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $126.26–$131.00. Rural fees can be higher.
Does Medicare cover L8616?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L8616 change in 2026?
The average non-rural state fee moved from $125.91 in 2025 to $128.43 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8616 can be billed per day?
2 on outpatient hospital claims; 2 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
- 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)
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 L8616
- Watch L8616 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8616
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.