L8642 — Hallux implant
L8642 is a HCPCS Level II code for hallux implant. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
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 L8642 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
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
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 L8642
- Long descriptor
- Hallux implant
- Short descriptor
- Hallux implant
- Added
- January 1, 1992
- BETOS
- D1F
- Pricing indicator
- 38 — 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.
Orthotics, prosthetics, prosthetic devices and vision services. Price subject to floors and ceilings.
Codes adjacent to L8642
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L8642 is not quite right, the correct code is very often within a few positions of it.
- L8624Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each
- L8625External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each
- L8627Cochlear implant, external speech processor, component, replacement
- L8628Cochlear implant, external controller component, replacement
- L8629Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
- L8630Metacarpophalangeal joint implant
- L8631Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)
- L8641Metatarsal joint implant
- L8658Interphalangeal joint spacer, silicone or equal, each
- L8659Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size
- L8670Vascular graft material, synthetic, implant
- L8678Electrical stimulator supplies (external) for use with implantable neurostimulator, per month
- L8679Implantable neurostimulator, pulse generator, any type
- L8680Implantable neurostimulator electrode, each
- L8681Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only
- L8682Implantable neurostimulator radiofrequency receiver
Questions about L8642
What is HCPCS code L8642?
L8642 is a HCPCS Level II code for hallux implant. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L8642?
The CMS HCPCS file marks L8642 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.