L8604 — Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
L8604 is a HCPCS Level II code for injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies. 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 L8604 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
- 3 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 3 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 L8604
- Long descriptor
- Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
- Short descriptor
- Dextranomer/hyaluronic acid
- Added
- January 1, 2009
- BETOS
- D1F
- Pricing indicator
- 00 — Not priced by Part B
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.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to L8604
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L8604 is not quite right, the correct code is very often within a few positions of it.
- L8510Voice amplifier
- L8511Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each
- L8512Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10
- L8513Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each
- L8514Tracheoesophageal puncture dilator, replacement only, each
- L8515Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each
- L8600Implantable breast prosthesis, silicone or equal
- L8603Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies
- L8605Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies
- L8606Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies
- L8607Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies
- L8608Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system
- L8609Artificial cornea
- L8610Ocular implant
- L8612Aqueous shunt
- L8613Ossicula implant
Questions about L8604
What is HCPCS code L8604?
L8604 is a HCPCS Level II code for injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L8604?
The CMS HCPCS file marks L8604 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.