L8678 HCPCS code: Electrical stimulator supplies (external) for use with implantable neurostimulator, per month
L8678 is the HCPCS Level II code for electrical stimulator supplies (external) for use with implantable neurostimulator, per month. The 2026 Medicare DMEPOS fee schedule pays $11.40 to $31.64 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 DME suppliers. Its average fee ranks 3 of 43 L86 codes (family range $0.40–$23,640.75); rural fees run 97% higher.
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 | 2023-04-01 |
| Last action effective | 2023-04-01 |
2026 Medicare DMEPOS fee schedule for L8678
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $11.40 | $31.64 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $27.22 | — |
| AL | — | $13.24 | $27.55 |
| AR | — | $13.24 | $27.55 |
| AZ | — | $12.84 | $27.22 |
| CA | — | $11.40 | $27.22 |
| CO | — | $12.97 | $27.55 |
| CT | — | $12.95 | $27.55 |
| DC | — | $12.88 | $27.55 |
| DE | — | $12.88 | $27.55 |
| FL | — | $13.24 | $27.55 |
| GA | — | $13.24 | $27.55 |
| HI | — | $27.22 | — |
| IA | — | $12.25 | $27.22 |
| ID | — | $12.97 | $27.22 |
| IL | — | $12.72 | $27.55 |
| IN | — | $12.72 | $27.55 |
| KS | — | $12.25 | $27.22 |
| KY | — | $13.24 | $27.55 |
| LA | — | $13.24 | $27.55 |
| MA | — | $12.95 | $27.55 |
| MD | — | $12.88 | $27.55 |
| ME | — | $12.95 | $27.55 |
| MI | — | $12.72 | $27.55 |
| MN | — | $12.25 | $27.55 |
| MO | — | $12.25 | $27.55 |
| MS | — | $13.24 | $27.55 |
| MT | — | $12.97 | $27.22 |
| NC | — | $13.24 | $27.55 |
| ND | — | $12.25 | $27.22 |
| NE | — | $12.25 | $27.22 |
| NH | — | $12.95 | $27.55 |
| NJ | — | $12.88 | $27.55 |
| NM | — | $12.84 | $27.55 |
| NV | — | $11.40 | $27.22 |
| NY | — | $12.88 | $27.55 |
| OH | — | $12.72 | $27.55 |
| OK | — | $12.84 | $27.55 |
| OR | — | $11.40 | $27.22 |
| PA | — | $12.88 | $27.55 |
| PR | — | $31.64 | — |
| RI | — | $12.95 | $27.55 |
| SC | — | $13.24 | $27.55 |
| SD | — | $12.25 | $27.22 |
| TN | — | $13.24 | $27.55 |
| TX | — | $12.84 | $27.55 |
| UT | — | $12.97 | $27.55 |
| VA | — | $13.24 | $27.55 |
| VI | — | $27.55 | — |
| VT | — | $12.95 | $27.55 |
| WA | — | $11.40 | $27.55 |
| WI | — | $12.72 | $27.55 |
| WV | — | $13.24 | $27.55 |
| WY | — | $12.97 | $27.22 |
How the L8678 fee compares
| Measure | Value |
|---|---|
| Rank among 43 L86 codes (lowest = 1) | 3 |
| Family fee range (average of state fees) | $0.40–$23,640.75 |
| Rural fee uplift | 97.1% |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1 | Code Descriptor / CPT Instruction |
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A59332: Billing and Coding: Sacral Nerve Stimulation for the Treatment of Urinary and Fecal Incontinence (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (45 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| N30.10 | Interstitial cystitis (chronic) without hematuria | 1 |
| N30.11 | Interstitial cystitis (chronic) with hematuria | 1 |
| N32.81 | Overactive bladder | 1 |
| N39.41 | Urge incontinence | 1 |
| N39.42 | Incontinence without sensory awareness | 1 |
| N39.46 | Mixed incontinence | 1 |
| N39.490 | Overflow incontinence | 1 |
| N39.492 | Postural (urinary) incontinence | 1 |
| N39.498 | Other specified urinary incontinence | 1 |
| R15.9 | Full incontinence of feces | 1 |
Showing 10 of 45. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for L8678
- 2026-01-01: Average state fee rose 2.6%: $13.58 to $13.94
- 2023-04-01: L8678 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 L8678?
L8678 is the HCPCS Level II code for electrical stimulator supplies (external) for use with implantable neurostimulator, per month. Short descriptor: "Ext sply implt neurostim".
How much does Medicare pay for L8678?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $11.40–$31.64. Rural fees can be higher.
Does Medicare cover L8678?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for L8678?
Medicare policy articles that cite L8678 list 45 covered ICD-10-CM diagnosis codes across 1 article. The most cited include N30.10 (Interstitial cystitis (chronic) without hematuria), N30.11 (Interstitial cystitis (chronic) with hematuria), N32.81 (Overactive bladder). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for L8678 change in 2026?
The average non-rural state fee moved from $13.58 in 2025 to $13.94 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8678 can be billed per day?
1 on DME suppliers; 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
- 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 L8678
- Watch L8678 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8678
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.