Braces; trusses; and artifical legs, arms, and eyes are covered when furnished incident to a physician’s services or on a physician’s order. A brace includes rigid and semirigid devices used for the purpose of supporting a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body. Back braces include, but are not limited to, sacroiliac, sacrolumbar, dorsolumbar corsets, and belts. Stump stockings and harnesses (including replacements) are also covered when these appliances are essential to the effective use of an artificial limb. Adjustments to an artificial limb or other appliance required by wear or by a change in the patient’s condition are covered when ordered by a physician. Adjustments, repairs, and replacements are covered so long as the device continues to be medically required.


  • L8047

    Nasal septal prosthesis, provided by a non-physician
  • L8048

    Unspecified maxillofacial prosthesis, by report, provided by a non-physician
  • L8049

    Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician
  • L8300

    Truss, single with standard pad
  • L8310

    Truss, double with standard pads
  • L8320

    Truss, addition to standard pad, water pad
  • L8330

    Truss, addition to standard pad, scrotal pad
  • L8400

    Prosthetic sheath, below knee, each
  • L8410

    Prosthetic sheath, above knee, each
  • L8415

    Prosthetic sheath, upper limb, each


  • Continued
  • L8417

    Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each
  • L8420

    Prosthetic sock, multiple ply, below knee, each
  • L8430

    Prosthetic sock, multiple ply, above knee, each
  • L8435

    Prosthetic sock, multiple ply, upper limb, each
  • L8440

    Prosthetic shrinker, below knee, each
  • L8460

    Prosthetic shrinker, above knee, each
  • L8465

    Prosthetic shrinker, upper limb, each
  • L8470

    Prosthetic sock, single ply, fitting, below knee, each
  • L8480

    Prosthetic sock, single ply, fitting, above knee, each
  • L8485

    Prosthetic sock, single ply, fitting, upper limb, each
  • L8499

    Unlisted procedure for miscellaneous prosthetic services
  • L8500

    Artificial larynx, any type
  • L8501

    Tracheostomy speaking valve
  • L8505

    Artificial larynx replacement battery / accessory, any type
  • L8507

    Tracheo-esophageal voice prosthesis, patient inserted, any type, each
  • L8509

    Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type
  • L8510

    Voice amplifier
  • L8511

    Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each
  • L8512

    Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10
  • L8513

    Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each


  • Continued
  • L8514

    Tracheoesophageal puncture dilator, replacement only, each
  • L8515

    Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each
  • L8600

    Implantable breast prosthesis, silicone or equal
  • L8603

    Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies
  • 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
  • L8606

    Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies
  • L8607

    Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies
  • L8608

    Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system
  • L8609

    Artificial cornea
  • L8610

    Ocular implant
  • L8612

    Aqueous shunt
  • L8613

    Ossicula implant
  • L8614

    Cochlear device, includes all internal and external components
  • L8615

    Headset/headpiece for use with cochlear implant device, replacement
  • L8616

    Microphone for use with cochlear implant device, replacement
  • L8617

    Transmitting coil for use with cochlear implant device, replacement
  • L8618

    Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement
  • L8619

    Cochlear implant, external speech processor and controller, integrated system, replacement
  • L8621

    Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each