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HCPCS Procedure & Supply Codes

Prosthetic Procedures

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General

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Breast Prosthesis

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L8000   Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, an...
L8001   Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unila...
L8002   Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilat...
L8010   Breast prosthesis, mastectomy sleeve
L8015   External breast prosthesis garment, with mastectomy form, post mastectomy
L8020   Breast prosthesis, mastectomy form
L8030   Breast prosthesis, silicone or equal, without integral adhesive
L8031   Breast prosthesis, silicone or equal, with integral adhesive
L8032   Nipple prosthesis, prefabricated, reusable, any type, each
L8033   Nipple prosthesis, custom fabricated, reusable, any material, any type, each
L8035   Custom breast prosthesis, post mastectomy, molded to patient model
L8039   Breast prosthesis, not otherwise specified
L8040   Nasal prosthesis, provided by a non-physician
L8041   Midfacial prosthesis, provided by a non-physician
L8042   Orbital prosthesis, provided by a non-physician
L8043   Upper facial prosthesis, provided by a non-physician
L8044   Hemi-facial prosthesis, provided by a non-physician
L8045   Auricular prosthesis, provided by a non-physician
L8046   Partial facial prosthesis, provided by a non-physician
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 i...
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