L8430 — Prosthetic sock, multiple ply, above knee, each
L8430 is a HCPCS Level II code for prosthetic sock, multiple ply, above knee, each. 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 L8430 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
- 12 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 24 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 L8430
- Long descriptor
- Prosthetic sock, multiple ply, above knee, each
- Short descriptor
- Prosthetic sock multi ply ak
- Added
- January 1, 1982
- 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 L8430
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L8430 is not quite right, the correct code is very often within a few positions of it.
- 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
- L8420Prosthetic sock, multiple ply, below knee, each
- L8435Prosthetic sock, multiple ply, upper limb, each
- L8440Prosthetic shrinker, below knee, each
- L8460Prosthetic shrinker, above knee, each
- L8465Prosthetic shrinker, upper limb, each
- L8470Prosthetic sock, single ply, fitting, below knee, each
- L8480Prosthetic sock, single ply, fitting, above knee, each
- L8485Prosthetic sock, single ply, fitting, upper limb, each
- L8499Unlisted procedure for miscellaneous prosthetic services
Questions about L8430
What is HCPCS code L8430?
L8430 is a HCPCS Level II code for prosthetic sock, multiple ply, above knee, each. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L8430?
The CMS HCPCS file marks L8430 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.