L8020 – Breast prosthesis, mastectomy form

HCPCS Level II code · L codes: Orthotic and Prosthetic Procedures and Devices

Active code Special coverage instructions apply

HCPCS codeL8020
Long description
Breast prosthesis, mastectomy form
Short description
Mastectomy form
Pricing indicator
38 Orthotics, prosthetics, prosthetic devices & vision services
Medicare coverage
D Special coverage instructions apply
BETOS category
D1F Prosthetic/Orthotic devices
Added
January 1, 1986
Last change
January 1, 1996 – No change

Frequently asked questions

What is HCPCS code L8020?

L8020 is a HCPCS Level II code for breast prosthesis, mastectomy form.

Does Medicare cover L8020?

The HCPCS file lists coverage code D: Special coverage instructions apply. Coverage and payment also depend on local coverage determinations and the patient’s plan.

Nearby L codes

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.