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See a sample rate comparisonHCPCS L8049 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Facial and External Ear Prosthetics |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L8049 |
National average reimbursement for HCPCS L8049 by major payers:
$25.70
$15.36
$31.07
$11.08
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HCPCS L8049
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$48.58Published rateThe Hospital Authority Of Habersham County
$19.87Published rateHospital Authority Of Ben Hill, Dorminy Medical Center
$14.35Published rateEvans Memorial Hospital, Inc.
Evans Memorial Hospital Inc
$13.25Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$13.25Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L8049 vs. Other Facial and External Ear Prosthetics Codes
The HCPCS L8049 code is part of the Prosthetic Procedures services used for Facial and External Ear Prosthetics. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS L8049 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| L8048-HCPCS | High | Unspecified maxillofacial prosthesis, by report, provided by a non-physician |
| L8049-HCPCS | Low | Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician |
| L8300-HCPCS | Low | Truss, single with standard pad |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8049. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8049 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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