L8613: Ossicula implant
L8613 is a HCPCS Level II code for ossicula 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 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits: units per day
The most units of L8613 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
- 1 unit MAI 3: Date of Service Edit: Clinical · Clinical: Data
- 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 2026Q4.
The CMS record for L8613
- Long descriptor
- Ossicula implant
- Short descriptor
- Ossicular 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 L8613
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If L8613 is not quite right, the correct code is very often within a few positions of it.
- L8604Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, 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
- L8614Cochlear device, includes all internal and external components
- L8615Headset/headpiece for use with cochlear implant device, replacement
- L8616Microphone for use with cochlear implant device, replacement
- L8617Transmitting coil for use with cochlear implant device, replacement
- L8618Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement
- L8619Cochlear implant, external speech processor and controller, integrated system, replacement
- L8621Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each
- L8622Alkaline battery for use with cochlear implant device, any size, replacement, each