L8604 – Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies

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

Active code Carrier judgment

HCPCS codeL8604
Long description
Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies
Short description
Dextranomer/hyaluronic acid
Pricing indicator
00 Not separately priced by Part B (bundled, not covered or Part A only)
Medicare coverage
C Carrier judgment – coverage decided by the Medicare contractor
BETOS category
D1F Prosthetic/Orthotic devices
Added
January 1, 2009
Last change
January 1, 2009 – No change

Frequently asked questions

What is HCPCS code L8604?

L8604 is a HCPCS Level II code for injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies.

Does Medicare cover L8604?

The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. 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.