L80 — HCPCS Level II Codes

• L8000 Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type billable
• L8001 Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type billable
• L8002 Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type billable
• L8015 External breast prosthesis garment, with mastectomy form, post mastectomy billable
• L8020 Breast prosthesis, mastectomy form billable
• L8030 Breast prosthesis, silicone or equal, without integral adhesive billable
• L8031 Breast prosthesis, silicone or equal, with integral adhesive billable
• L8032 Nipple prosthesis, prefabricated, reusable, any type, each billable
• L8033 Nipple prosthesis, custom fabricated, reusable, any material, any type, each billable
• L8035 Custom breast prosthesis, post mastectomy, molded to patient model billable
• L8039 Breast prosthesis, not otherwise specified billable
• L8040 Nasal prosthesis, provided by a non-physician billable
• L8041 Midfacial prosthesis, provided by a non-physician billable
• L8042 Orbital prosthesis, provided by a non-physician billable
• L8043 Upper facial prosthesis, provided by a non-physician billable
• L8044 Hemi-facial prosthesis, provided by a non-physician billable
• L8045 Auricular prosthesis, provided by a non-physician billable
• L8046 Partial facial prosthesis, provided by a non-physician billable
• L8047 Nasal septal prosthesis, provided by a non-physician billable
• L8048 Unspecified maxillofacial prosthesis, by report, provided by a non-physician billable
• L8049 Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician billable