L8049 — Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician
L8049 is a HCPCS Level II code for repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of L8049 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 6 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
- DME supplier
- 6 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for L8049
- Long descriptor
- Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician
- Short descriptor
- Repair maxillofacial prosth
- Added
- January 1, 2001
- BETOS
- D1F
- Pricing indicator
- 46 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Carrier priced — not otherwise classified, individual determination, carrier discretion, or gap-filled amounts.
Codes adjacent to L8049
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L8049 is not quite right, the correct code is very often within a few positions of it.
- L8041Midfacial prosthesis, provided by a non-physician
- L8042Orbital prosthesis, provided by a non-physician
- L8043Upper facial prosthesis, provided by a non-physician
- L8044Hemi-facial prosthesis, provided by a non-physician
- L8045Auricular prosthesis, provided by a non-physician
- L8046Partial facial prosthesis, provided by a non-physician
- L8047Nasal septal prosthesis, provided by a non-physician
- L8048Unspecified maxillofacial prosthesis, by report, provided by a non-physician
- L8300Truss, single with standard pad
- L8310Truss, double with standard pads
- L8320Truss, addition to standard pad, water pad
- L8330Truss, addition to standard pad, scrotal pad
- L8400Prosthetic sheath, below knee, each
- L8410Prosthetic sheath, above knee, each
- L8415Prosthetic sheath, upper limb, each
- L8417Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each
Questions about L8049
What is HCPCS code L8049?
L8049 is a HCPCS Level II code for repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L8049?
The CMS HCPCS file marks L8049 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.