HCPCS L8000: Mastectomy Bra without Integrated Prosthesis

HCPCS Level II code L8000 describes a mastectomy bra without an integrated breast prosthesis form, provided as external post-mastectomy apparel; the service is breast prosthesis attire intended to support and accommodate the post-surgical chest wall, typically supplied in an outpatient clinical setting or durable medical equipment supplier or specialty prosthetics/lingerie retail location.

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HCPCS L8000: Mastectomy Bra without Integrated Prosthesis

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Get alerted when payer policies referencing L8000 are released or updated.

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Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is a woman status post unilateral or bilateral mastectomy for breast cancer who requires external breast prosthesis and a mastectomy bra to accommodate the prosthesis. The patient visits an outpatient durable medical equipment or prosthetics clinic, breast center, or specialty medical supply vendor. Clinical workflow: clinician documents medical necessity in the chart (e.g., history of mastectomy, current prosthesis need, skin integrity, and laterality). A prescription or order for a mastectomy bra without integrated prosthetic form is provided. The vendor verifies insurance coverage and beneficiary eligibility (for example, Medicare, Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA), selects appropriate size and type, fits the patient in the mastectomy bra, and dispenses the item. Education is provided on wear, care, and follow-up for changes in fit or post-surgical changes. Billing uses HCPCS Level II code L8000 and may include a modifier for laterality, place of service, or replacement circumstances.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19303`	Mastectomy, simple, complete	Surgical procedure that results in the clinical need for a mastectomy bra and external prosthesis
`19301`	Partial mastectomy (lumpectomy)	May result in need for specialized camisoles or partial-breast prosthetic solutions
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	Used in some outpatient settings to bill for non-routine supplies associated with fitting when payer allows
`S5160`	Prosthesis, external, breast (mammary) — used historically in some local codes	Related supply code used in certain state Medicaid or private plans; may be used alongside `L8000` for reimbursement context
`A9270`	Non-covered item or service	Used by some payers to indicate items not covered; included here because supplier/payer communication may reference it during benefits determination

Related Modifiers

5 rows

Modifier	Description	When to Use
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
171WH0202X	Home Modifications Contractor	A contractor who makes modifications to homes to accommodate a health condition.
1223X0008X	Oral and Maxillofacial Radiology Dentistry	The specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities …
207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency de…
207YX0901X	Otology & Neurotology Physician	An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology a…

HCPCS Level II L5000: Partial Foot Shoe Insert with Longitudinal Arch, Toe Filler

HCPCS-L5010-PARTIAL-FOOT-MOLDED-SOCKET-ANKLE-HEIGHT-TOE-FILLER

HCPCS L5010: Partial Foot Molded Socket, Ankle Height, With Toe Filler

HCPCS-L5020-PARTIAL-FOOT-MOLDED-SOCKET-TIBIAL-TUBERCLE-TOE-FILLER

HCPCS L5020: Partial Foot Molded Socket with Toe Filler

HCPCS-L5050-ANKLE-SYMES-MOLDED-SOCKET-SACH-FOOT

HCPCS L5050: Ankle/Symes Molded Socket with SACH Foot

HCPCS-L5060-ANKLE-SYMES-METAL-FRAME-MOLDED-LEATHER-SOCKET-ARTICULATED-ANKLE-FOOT

HCPCS L5060: Ankle/Symes Metal Frame with Molded Leather Socket

HCPCS-L5100-BELOW-KNEE-MOLDED-SOCKET-SHIN-SACH-FOOT

HCPCS Level II L5100: Below-Knee Molded Socket with Shin and SACH Foot

HCPCS-L5105-BELOW-KNEE-PLASTIC-SOCKET-SACH-FOOT

HCPCS L5105: Below-Knee Plastic Socket Prosthesis with SACH Foot

HCPCS-L5150-KNEE-DISARTICULATION-MOLDED-SOCKET-EXTERNAL-KNEE-SACH-FOOT

HCPCS L5150: Knee Disarticulation Molded Socket with External Knee and SACH Foot

HCPCS-L5160-KNEE-DISARTICULATION-MOLDED-SOCKET-BENT-KNEE-SACH-FOOT

HCPCS Level II L5160: Knee Disarticulation Molded Socket, Bent Knee Configuration

HCPCS-L5200-ABOVE-KNEE-MOLDED-SOCKET-SINGLE-AXIS-KNEE-SACH-FOOT

HCPCS Level II L5200: Above-knee Prosthesis with Molded Socket and Single-axis Knee

Showing 1–10 of 472

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`19303`	Mastectomy, simple, complete	Surgical procedure that results in the clinical need for a mastectomy bra and external prosthesis
`19301`	Partial mastectomy (lumpectomy)	May result in need for specialized camisoles or partial-breast prosthetic solutions
`99070`	Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit	Used in some outpatient settings to bill for non-routine supplies associated with fitting when payer allows
`S5160`	Prosthesis, external, breast (mammary) — used historically in some local codes	Related supply code used in certain state Medicaid or private plans; may be used alongside `L8000` for reimbursement context
`A9270`	Non-covered item or service	Used by some payers to indicate items not covered; included here because supplier/payer communication may reference it during benefits determination

Related Modifiers

5 rows

Modifier	Description	When to Use
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
163W00000X	Registered Nurse	(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
171WH0202X	Home Modifications Contractor	A contractor who makes modifications to homes to accommodate a health condition.
1223X0008X	Oral and Maxillofacial Radiology Dentistry	The specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities …
207PP0204X	Pediatric Emergency Medicine (Emergency Medicine) Physician	Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency de…
207YX0901X	Otology & Neurotology Physician	An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology a…

HCPCS Level II L5000: Partial Foot Shoe Insert with Longitudinal Arch, Toe Filler

HCPCS-L5010-PARTIAL-FOOT-MOLDED-SOCKET-ANKLE-HEIGHT-TOE-FILLER

HCPCS L5010: Partial Foot Molded Socket, Ankle Height, With Toe Filler

HCPCS-L5020-PARTIAL-FOOT-MOLDED-SOCKET-TIBIAL-TUBERCLE-TOE-FILLER

HCPCS L5020: Partial Foot Molded Socket with Toe Filler

HCPCS-L5050-ANKLE-SYMES-MOLDED-SOCKET-SACH-FOOT

HCPCS L5050: Ankle/Symes Molded Socket with SACH Foot

HCPCS-L5060-ANKLE-SYMES-METAL-FRAME-MOLDED-LEATHER-SOCKET-ARTICULATED-ANKLE-FOOT

HCPCS L5060: Ankle/Symes Metal Frame with Molded Leather Socket

HCPCS-L5100-BELOW-KNEE-MOLDED-SOCKET-SHIN-SACH-FOOT

HCPCS Level II L5100: Below-Knee Molded Socket with Shin and SACH Foot

HCPCS-L5105-BELOW-KNEE-PLASTIC-SOCKET-SACH-FOOT

HCPCS L5105: Below-Knee Plastic Socket Prosthesis with SACH Foot

HCPCS-L5150-KNEE-DISARTICULATION-MOLDED-SOCKET-EXTERNAL-KNEE-SACH-FOOT

HCPCS L5150: Knee Disarticulation Molded Socket with External Knee and SACH Foot

HCPCS-L5160-KNEE-DISARTICULATION-MOLDED-SOCKET-BENT-KNEE-SACH-FOOT

HCPCS Level II L5160: Knee Disarticulation Molded Socket, Bent Knee Configuration

HCPCS-L5200-ABOVE-KNEE-MOLDED-SOCKET-SINGLE-AXIS-KNEE-SACH-FOOT

HCPCS Level II L5200: Above-knee Prosthesis with Molded Socket and Single-axis Knee

Showing 1–10 of 472

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS L8000: Mastectomy Bra without Integrated Prosthesis

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OpenPayer

HCPCS L8000: Mastectomy Bra without Integrated Prosthesis

Sign up for hcpcs L8000 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

HCPCS L8000: Mastectomy Bra without Integrated Prosthesis

Sign up for hcpcs L8000 policy alerts

HCPCS L8000: Mastectomy Bra without Integrated Prosthesis

Sign up for hcpcs L8000 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L8000 represent?

Which payers commonly cover L8000 and do coverage requirements vary?

Which modifiers are commonly used with L8000 and when should they be applied?

Which diagnosis codes and clinical documentation support billing L8000?

Where is a mastectomy bra (L8000) typically supplied and what is the clinical workflow?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L8000 represent?

Which payers commonly cover L8000 and do coverage requirements vary?

Which modifiers are commonly used with L8000 and when should they be applied?

Which diagnosis codes and clinical documentation support billing L8000?

Where is a mastectomy bra (L8000) typically supplied and what is the clinical workflow?

References