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HCPCS L8609 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Artificial cornea
Key FactDetail
Service Type

Prosthetic Procedures

Implantable Eye and Ear Prosthetics and Accessories

Complexity LevelHigh

National average reimbursement for HCPCS L8609 by major payers:

bcbs

$6,596.52

uhc

$4,244.32

aetna

$4,682.17

cigna

$6,382.87

Preview provider-level rates for...
For billing codeHCPCS L8609
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L8609

United
L8609$4160.121851400485 - GEORGE HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L8609$3506.321851400485 - GEORGE HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L8609$3506.321013553197 - AMY MOORE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALAcute Care Nurse Practitioner (363LA2100X)
United
L8609$4160.121851400485 - GEORGE HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L8609$3506.321679845531 - DANA HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALFamily Nurse Practitioner (363LF0000X)
United
L8609$3506.321952557498 - JEREMY KELLEY451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALFamily Nurse Practitioner (363LF0000X)
United
L8609$14043.211073502985 - CHU CHEN42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L8609$14043.211073502985 - CHU CHEN42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L8609$3506.321790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L8609$3713.691790942381 - TATTNALL HOSPITAL COMPANY, LLC, OPTIM MEDICAL CENTER - TATTNALL300466706GACritical Access Hospital (282NC0060X)
United
L8609$3720.691235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER586002922GARural Acute Care Hospital (282NR1301X)
United
L8609$3780.611811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM474393589 - (GA) EFFINGHAM HOSPITAL INCGACritical Access Hospital (282NC0060X)
United
L8609$13404.891073502985 - CHU CHEN42484572MAPediatrics Physician (208000000X)
United
L8609$3434.611326028978 - CHATUGE REGIONAL HOSPITAL INC582513901 - CHATUGE REGIONAL HOSPITAL INCGACritical Access Hospital (282NC0060X)
United
L8609$3434.611760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTERGACritical Access Hospital (282NC0060X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS L8609 vs. Other Implantable Eye and Ear Prosthetics and Accessories Codes

The HCPCS L8609 code is part of the Prosthetic Procedures services used for Implantable Eye and Ear Prosthetics and Accessories. 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 L8609 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.

CodeComplexityDescription
L8608-HCPCSModerateMiscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system
L8609-HCPCSHighArtificial cornea
L8610-HCPCSModerateOcular implant

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8609. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L8609 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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