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    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l8048-unspecified-maxillofacial-prosthesis-non-physician
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    HCPCS L8048: Unspecified Maxillofacial Prosthesis, Non-Physician

    HCPCS Level II code L8048 describes an unspecified maxillofacial prosthesis provided by a non-physician and reported with supporting documentation; the service is a prosthetic maxillofacial appliance typically fabricated and delivered by a dental or anaplastology prosthetics provider and furnished in an outpatient clinic, dental office, or specialized prosthetics laboratory setting.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria — Lymphedema Therapy and Training (Complete Decongestive Therapy; LVA), Therapy Services — Electric Stimulation for Pain, Swelling and Function in a Clinic Setting, Site of Care: Outpatient Hospital Setting for Physical and Occupational Therapy.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult who has undergone maxillofacial resection or has traumatic facial defects requiring a custom prosthetic restoration. The prosthesis described by L8048 is an unspecified maxillofacial prosthesis fabricated and provided by a non-physician prosthetist or maxillofacial prosthetics specialist. Workflow: initial consultation with the surgical or oncology team documents the defect and goals; impressions and facial measurements are taken by the prosthetics clinician in an outpatient prosthetics clinic or dental-prosthetics lab; a custom prosthesis is fabricated (often in stages: impression, wax try-in, final fabrication); trial fitting and adjustments are performed; final delivery and patient education are provided. Typical sites of service include outpatient prosthetics/dental clinics, ambulatory surgery centers for complex fittings, hospital-based prosthetics departments, and specialized maxillofacial prosthetics laboratories. Common indications include post-oncologic resection (e.g., maxillectomy, rhinectomy), traumatic loss, congenital craniofacial anomalies, or failed reconstructive surgery where a prosthetic solution restores facial form and function.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    70350CT scan, maxillofacial area; without contrast materialImaging used pre-prosthesis to evaluate bony structures and defect anatomy for prosthetic planning.
    70360CT scan, maxillofacial area; with contrast materialWhen contrast-enhanced imaging is needed for surgical planning prior to prosthetic rehabilitation.
    70486CT maxillofacial without contrast, limited areaLimited or focused CT used for targeted assessment of defect margins to guide prosthesis fabrication.
    41899Unlisted procedure, dentoalveolar structuresUsed by dental or prosthetic providers to report specific unlisted clinical procedures related to impressions, intraoral frameworks, or specialized fittings not captured by standard CPT codes.
    92700Non-specific swallowing or oral function evaluation (example code for oral function assessment)Functional assessments that may be performed when maxillofacial prostheses impact speech, mastication, or swallowing; used in coordination with prosthetic rehabilitation.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    22Modifier –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…
    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…
    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…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    251B00000XCase Management AgencyAn organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
    332B00000XDurable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    315P00000XIntellectual Disabilities Intermediate Care FacilityAn intermediate care facility providing services for individuals with intellectual disabilities.
    224900000XMastectomy FitterAn individual trained in the fitting and adjusting of breast prostheses and management of post-mastectomy prostheses services.
    221700000XArt Therapist(1) An individual who uses art to achieve the therapeutic goals of symptom relief, emotional integration, and recovery from or adjustment to illness o…
    261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    332100000XDepartment of Veterans Affairs (VA) PharmacyDepartment of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to en…

    Related Payer Policy Updates

    Specialty: Physical Medicine, Rehab & Therapies1 / 2

    3 rows

    PolicyPayerEffective Date
    Clinical Review Criteria — Lymphedema Therapy and Training (Complete Decongestive Therapy; LVA)Kaiser Permanente2026-09-01
    Therapy Services — Electric Stimulation for Pain, Swelling and Function in a Clinic SettingCigna2026-08-15
    Site of Care: Outpatient Hospital Setting for Physical and Occupational TherapyCigna2026-08-15

    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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