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    v1.0.28
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l8044-hemi-facial-prosthesis-non-physician
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    HCPCS Level II L8044: Hemi-facial Prosthesis, Non-Physician

    HCPCS Level II code L8044 describes a hemi-facial prosthesis fabricated and provided by a non-physician provider, representing a prosthetic device service typically delivered by a prosthetist or anaplastologist in an outpatient clinic or prosthetics/facial prosthetics specialty setting for restoration of facial form after hemi-facial loss or defect.

    For related coverage guidance, see recent payer policy updates: Skilled Nursing and Skilled Rehabilitation Services (Outpatient), Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Mexico Only), Physical Therapy/Medicine Corporate Medical Policy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old male with a history of squamous cell carcinoma of the left cheek underwent surgical resection with partial maxillectomy and wide local excision resulting in a significant hemi-facial soft-tissue defect. Reconstruction with local flaps was limited by prior radiation and tissue loss; the patient is referred to a maxillofacial prosthetist for fabrication of a custom hemi-facial prosthesis to restore facial contour and psychosocial function. The clinical workflow includes an initial prosthetic consultation and facial assessment, acquisition of facial impressions and digital scans, fabrication of a custom silicone prosthesis matched to skin tone and contours, fitting and adjustment sessions, patient education on prosthesis application and care, and issuance of a replacement/care plan. The service is provided by a non-physician prosthetist or anaplastologist working in an outpatient prosthetics clinic or a specialized maxillofacial prosthetics center. Typical site of service is an outpatient clinic or ambulatory prosthetics facility. Follow-up visits for refitting or modifications occur as needed, with periodic replacement over time due to wear, color change, or anatomical changes.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11970Replacement of external prosthesis, facial (e.g., ear, nose, eye)Used when a previously issued facial prosthesis requires replacement; closely related to maintenance/replacement of a hemi-facial prosthesis
    21010Incision and drainage of facial abscess or hematoma; superficialMay precede prosthetic fitting if debridement or drainage of wound/collection is required prior to impression and prosthesis fabrication
    92507Treatment of speech, language, voice, communication, and/or auditory processing disorder; individualRelated when prosthetic rehabilitation includes speech or communication therapy due to facial defect impact
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visitUsed to bill ancillary supplies related to prosthesis fitting (adhesives, cleaning supplies) when payor policy permits
    P9960Orthotic/prosthetic supply; replacement, repair, or adjustmentUsed by some payors for repair or adjustment services associated with the prosthesis

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –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…
    52Modifier ‑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…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2080P0202XPediatric Cardiology PhysicianA pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    363LF0000XFamily Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    207SG0205XPh.D. Medical Genetics PhysicianA medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program and serves as a consultant to medi…
    163WC2100XContinence Care Registered NurseNursing Service Providers · Registered Nurse
    225000000XOrthotic FitterAn individual trained in the management of fitting prefabricated orthoses.
    225XN1300XNeurorehabilitation Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers · Occupational Therapist
    156FC0801XContact Lens FitterAn optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact …

    Related ICD-10-CM Codes

    14 rows

    ICD-10-CM CodeDescription
    C07Malignant neoplasm of parotid gland
    C09.0Malignant neoplasm of tonsillar fossa
    C09.1Malignant neoplasm of tonsillar pillar (anterior) (posterior)
    C09.8Malignant neoplasm of overlapping sites of tonsil
    C09.9Malignant neoplasm of tonsil, unspecified
    C44.319Basal cell carcinoma of skin of other parts of face
    C44.90Unspecified malignant neoplasm of skin, unspecified
    D04.0Carcinoma in situ of skin of lip
    D04.9Carcinoma in situ of skin, unspecified
    M26.69Other specified disorders of temporomandibular joint

    Showing 1–10 of 14

    Related Payer Policy Updates

    Specialty: Physical Medicine, Rehab & Therapies1 / 2

    10 rows

    PolicyPayerEffective Date
    Skilled Nursing and Skilled Rehabilitation Services (Outpatient)Anthem2026-10-01
    Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Mexico Only)UnitedHealthcare2026-10-01
    Physical Therapy/Medicine Corporate Medical Policybcbsvermont2026-10-01
    Cognitive Rehabilitation Corporate Medical Policybcbsvermont2026-10-01
    Speech Language Pathology/Therapy Services Corporate Medical Policybcbsvermont2026-10-01
    Occupational Therapy Corporate Medical Policybcbsvermont2026-10-01
    Biomagnetic TherapyConnectiCare2026-09-11
    Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Idaho Only)UnitedHealthcare2026-09-01
    Rehabilitation Services (Physical, Occupational, and Speech Therapy)UnitedHealthcare2026-09-01
    Manipulative Therapy (for Tennessee Only)UnitedHealthcare2026-09-01

    Related Codes

    HCPCS-L5000-PARTIAL-FOOT-SHOE-INSERT-LONGITUDINAL-ARCH-TOE-FILLER

    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

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    Frequently Asked Questions

    References

    1. 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. 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. 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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