L8691 HCPCS code: Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each
L8691 is the HCPCS Level II code for auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each. The 2026 Medicare DMEPOS fee schedule pays $2,069.73 to $2,276.70 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. Medicare volume fell 43% from 2022 to 2024 (1,588 to 906 services). In 2024, about 8 clinicians billed Medicare for L8691 for 872 beneficiaries. Its average fee ranks 32 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 | 2007-01-01 |
| Last action effective | 2018-01-01 |
2026 Medicare DMEPOS fee schedule for L8691
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $2,069.73 | $2,276.70 | $2,526.46 | $1,894.85 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $2,069.73 | — |
| AL | — | $2,132.09 | — |
| AR | — | $2,131.89 | — |
| AZ | — | $2,069.73 | — |
| CA | — | $2,069.73 | — |
| CO | — | $2,148.14 | — |
| CT | — | $2,069.73 | — |
| DC | — | $2,069.73 | — |
| DE | — | $2,069.73 | — |
| FL | — | $2,132.09 | — |
| GA | — | $2,132.09 | — |
| HI | — | $2,069.73 | — |
| IA | — | $2,110.18 | — |
| ID | — | $2,069.73 | — |
| IL | — | $2,120.58 | — |
| IN | — | $2,120.58 | — |
| KS | — | $2,110.18 | — |
| KY | — | $2,132.09 | — |
| LA | — | $2,131.89 | — |
| MA | — | $2,069.73 | — |
| MD | — | $2,069.73 | — |
| ME | — | $2,069.73 | — |
| MI | — | $2,120.58 | — |
| MN | — | $2,120.58 | — |
| MO | — | $2,110.18 | — |
| MS | — | $2,132.09 | — |
| MT | — | $2,148.14 | — |
| NC | — | $2,132.09 | — |
| ND | — | $2,148.14 | — |
| NE | — | $2,110.18 | — |
| NH | — | $2,069.73 | — |
| NJ | — | $2,069.73 | — |
| NM | — | $2,131.89 | — |
| NV | — | $2,069.73 | — |
| NY | — | $2,069.73 | — |
| OH | — | $2,120.58 | — |
| OK | — | $2,131.89 | — |
| OR | — | $2,069.73 | — |
| PA | — | $2,069.73 | — |
| PR | — | $2,276.70 | — |
| RI | — | $2,069.73 | — |
| SC | — | $2,132.09 | — |
| SD | — | $2,148.14 | — |
| TN | — | $2,132.09 | — |
| TX | — | $2,131.89 | — |
| UT | — | $2,148.14 | — |
| VA | — | $2,069.73 | — |
| VI | — | $2,276.70 | — |
| VT | — | $2,069.73 | — |
| WA | — | $2,069.73 | — |
| WI | — | $2,120.58 | — |
| WV | — | $2,069.73 | — |
| WY | — | $2,148.14 | — |
How the L8691 fee compares
| Measure | Value |
|---|---|
| Rank among 43 L86 codes (lowest = 1) | 32 |
| Family fee range (average of state fees) | $0.40–$23,640.75 |
| Rural fee uplift | — |
Who bills L8691 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 8 |
| Medicare beneficiaries | 872 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for L8691, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,588 | 1,507 | $1,774.85 | $1,415.07 |
| 2023 | 1,442 | 1,386 | $1,924.91 | $1,532.53 |
| 2024 | 906 | 872 | $1,969.65 | $1,566.64 |
States with the most L8691 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Colorado | 759 | $1,568.15 |
| New Jersey | 133 | $1,560.07 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Nature of Equipment |
| practitioner claims | 1 | Nature of Equipment |
What changed for L8691
- 2026-01-01: Average state fee rose 2.0%: $2,069.12 to $2,110.50
- 2007-01-01: L8691 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 L8691?
L8691 is the HCPCS Level II code for auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each. Short descriptor: "Aoi snd proc repl excl actua".
How much does Medicare pay for L8691?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $2,069.73–$2,276.70. Rural fees can be higher.
Does Medicare cover L8691?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for L8691 change in 2026?
The average non-rural state fee moved from $2,069.12 in 2025 to $2,110.50 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of L8691 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
- 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 L8691
- Watch L8691 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for L8691
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.