L8659 HCPCS code: Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size
L8659 is the HCPCS Level II code for interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size. The 2026 Medicare DMEPOS fee schedule pays $2,319.17 to $2,407.00 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 4 per day on outpatient hospital claims. Medicare volume fell 17% from 2022 to 2023 (24 to 20 services). In 2023, about 1 clinicians billed Medicare for L8659 for 11 beneficiaries. Its average fee ranks 34 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 | 2004-01-01 |
| Last action effective | 2004-01-01 |
2026 Medicare DMEPOS fee schedule for L8659
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $2,319.17 | $2,407.00 | $2,830.92 | $2,123.19 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AL | — | $2,388.97 | — |
| AR | — | $2,388.80 | — |
| AZ | — | $2,319.17 | — |
| CA | — | $2,319.17 | — |
| CO | — | $2,407.00 | — |
| CT | — | $2,319.17 | — |
| DC | — | $2,319.17 | — |
| DE | — | $2,319.17 | — |
| FL | — | $2,388.97 | — |
| GA | — | $2,388.97 | — |
| IA | — | $2,364.47 | — |
| ID | — | $2,319.17 | — |
| IL | — | $2,376.14 | — |
| IN | — | $2,376.14 | — |
| KS | — | $2,364.47 | — |
| KY | — | $2,388.97 | — |
| LA | — | $2,388.80 | — |
| MA | — | $2,319.17 | — |
| MD | — | $2,319.17 | — |
| ME | — | $2,319.17 | — |
| MI | — | $2,376.14 | — |
| MN | — | $2,376.14 | — |
| MO | — | $2,364.47 | — |
| MS | — | $2,388.97 | — |
| MT | — | $2,407.00 | — |
| NC | — | $2,388.97 | — |
| ND | — | $2,407.00 | — |
| NE | — | $2,364.47 | — |
| NH | — | $2,319.17 | — |
| NJ | — | $2,319.17 | — |
| NM | — | $2,388.80 | — |
| NV | — | $2,319.17 | — |
| NY | — | $2,319.17 | — |
| OH | — | $2,376.14 | — |
| OK | — | $2,388.80 | — |
| OR | — | $2,319.17 | — |
| PA | — | $2,319.17 | — |
| RI | — | $2,319.17 | — |
| SC | — | $2,388.97 | — |
| SD | — | $2,407.00 | — |
| TN | — | $2,388.97 | — |
| TX | — | $2,388.80 | — |
| UT | — | $2,407.00 | — |
| VA | — | $2,319.17 | — |
| VT | — | $2,319.17 | — |
| WA | — | $2,319.17 | — |
| WI | — | $2,376.14 | — |
| WV | — | $2,319.17 | — |
| WY | — | $2,407.00 | — |
How the L8659 fee compares
| Measure | Value |
|---|---|
| Rank among 43 L86 codes (lowest = 1) | 34 |
| Family fee range (average of state fees) | $0.40–$23,640.75 |
| Rural fee uplift | — |
Who bills L8659 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1 |
| Medicare beneficiaries | 11 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8659, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 24 | 17 | $1,975.00 | $1,576.82 |
| 2023 | 20 | 11 | $1,968.00 | $1,568.00 |
States with the most L8659 services (2023)
| State | Services | Avg. paid |
|---|---|---|
| California | 20 | $1,568.00 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | Clinical: Data |
| practitioner claims | 2 | Clinical: Data |
What changed for L8659
- 2026-01-01: Average state fee rose 2.0%: $2,312.84 to $2,359.10
- 2004-01-01: L8659 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 L8659?
L8659 is the HCPCS Level II code for interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size. Short descriptor: "Interphalangeal joint repl".
How much does Medicare pay for L8659?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $2,319.17–$2,407.00. Rural fees can be higher.
Does Medicare cover L8659?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for L8659 change in 2026?
The average non-rural state fee moved from $2,312.84 in 2025 to $2,359.10 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8659 can be billed per day?
4 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)
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Next steps
- Run a reimbursement report for a device billed under L8659
- Watch L8659 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8659
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.