# HCPCS L8420: Sheath for above knee prosthesis

Medicare HCPCS L8420 pays $27.28 on average under the 2026 Q4 Medicare DMEPOS Fee Schedule (non-rural). State amounts run from $23.81 in Wyoming to $47.61 in Puerto Rico, a 100% spread.

Web page: https://www.med-reveal.com/rates/L8420-hcpcs-fee-schedule
Section: DME, Prosthetics, Orthotics and Supplies

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $27.28 |
| National facility | $27.28 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Puerto Rico | $47.61 | $47.61 |
| Hawaii | $35.23 | $35.23 |
| Alaska | $32.94 | $32.94 |
| Arizona | $31.74 | $31.74 |
| California | $31.74 | $31.74 |
| Nevada | $31.74 | $31.74 |
| Alabama | $30.67 | $30.67 |
| Florida | $30.67 | $30.67 |
| Georgia | $30.67 | $30.67 |
| Kentucky | $30.67 | $30.67 |
| Mississippi | $30.67 | $30.67 |
| North Carolina | $30.67 | $30.67 |
| South Carolina | $30.67 | $30.67 |
| Tennessee | $30.67 | $30.67 |
| New Jersey | $27.60 | $27.60 |
| New York | $27.60 | $27.60 |
| Virgin Islands | $27.60 | $27.60 |
| Iowa | $26.38 | $26.38 |
| Kansas | $26.38 | $26.38 |
| Missouri | $26.38 | $26.38 |
| Nebraska | $26.38 | $26.38 |
| Illinois | $25.68 | $25.68 |
| Indiana | $25.68 | $25.68 |
| Michigan | $25.68 | $25.68 |
| Minnesota | $25.68 | $25.68 |
| Ohio | $25.68 | $25.68 |
| Wisconsin | $25.68 | $25.68 |
| Arkansas | $25.45 | $25.45 |
| Connecticut | $25.45 | $25.45 |
| Louisiana | $25.45 | $25.45 |
| Maine | $25.45 | $25.45 |
| Massachusetts | $25.45 | $25.45 |
| New Hampshire | $25.45 | $25.45 |
| New Mexico | $25.45 | $25.45 |
| Oklahoma | $25.45 | $25.45 |
| Rhode Island | $25.45 | $25.45 |
| Texas | $25.45 | $25.45 |
| Vermont | $25.45 | $25.45 |
| Delaware | $25.08 | $25.08 |
| District of Columbia | $25.08 | $25.08 |
| Maryland | $25.08 | $25.08 |
| Pennsylvania | $25.08 | $25.08 |
| Virginia | $25.08 | $25.08 |
| West Virginia | $25.08 | $25.08 |
| Idaho | $24.55 | $24.55 |
| Oregon | $24.55 | $24.55 |
| Washington | $24.55 | $24.55 |
| Colorado | $23.81 | $23.81 |
| Montana | $23.81 | $23.81 |
| North Dakota | $23.81 | $23.81 |
| South Dakota | $23.81 | $23.81 |
| Utah | $23.81 | $23.81 |
| Wyoming | $23.81 | $23.81 |

## Related codes

- L5000: Partial foot prosthesis, shoe insert with longitudinal arch, toe filler — https://www.med-reveal.com/rates/L5000-hcpcs-fee-schedule
- L5010: Partial foot prosthesis, molded socket, ankle height, soft interface — https://www.med-reveal.com/rates/L5010-hcpcs-fee-schedule
- L5050: Ankle symes prosthesis, molded socket — https://www.med-reveal.com/rates/L5050-hcpcs-fee-schedule
- L5100: Below knee prosthesis, molded socket, shin, SACH foot — https://www.med-reveal.com/rates/L5100-hcpcs-fee-schedule
- L5200: Above knee prosthesis, molded socket, single axis constant friction knee — https://www.med-reveal.com/rates/L5200-hcpcs-fee-schedule
- L5301: Below knee prosthesis, molded socket, shin, SACH foot, endoskeletal system — https://www.med-reveal.com/rates/L5301-hcpcs-fee-schedule
- L5321: Above knee prosthesis, molded socket, open end, endoskeletal system — https://www.med-reveal.com/rates/L5321-hcpcs-fee-schedule
- L5400: Immediate post-surgical or early fitting, application of initial rigid dressing — https://www.med-reveal.com/rates/L5400-hcpcs-fee-schedule

Commercial negotiated rates for L8420 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules