L8039 — Breast prosthesis, not otherwise specified
L8039 is a HCPCS Level II code for breast prosthesis, not otherwise specified. 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 L8039 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
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
- DME supplier
- 2 units MAI 3 — Date of Service Edit: Clinical · Anatomic Consideration
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 L8039
- Long descriptor
- Breast prosthesis, not otherwise specified
- Short descriptor
- Breast prosthesis nos
- Added
- January 1, 1998
- 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 L8039
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L8039 is not quite right, the correct code is very often within a few positions of it.
- L8010Breast prosthesis, mastectomy sleeveterminated
- L8015External breast prosthesis garment, with mastectomy form, post mastectomy
- L8020Breast prosthesis, mastectomy form
- L8030Breast prosthesis, silicone or equal, without integral adhesive
- L8031Breast prosthesis, silicone or equal, with integral adhesive
- L8032Nipple prosthesis, prefabricated, reusable, any type, each
- L8033Nipple prosthesis, custom fabricated, reusable, any material, any type, each
- L8035Custom breast prosthesis, post mastectomy, molded to patient model
- L8040Nasal prosthesis, provided by a non-physician
- 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
Questions about L8039
What is HCPCS code L8039?
L8039 is a HCPCS Level II code for breast prosthesis, not otherwise specified. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L8039?
The CMS HCPCS file marks L8039 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.