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    v1.0.28
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l8400-prosthetic-sheath-below-knee
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    HCPCS Level II L8400: Prosthetic Sheath, Below Knee

    HCPCS Level II code L8400 describes a prosthetic sheath for below-knee prostheses, intended to provide a protective or cushioning interface between a residual limb and a below-knee prosthetic socket; Service type: prosthetic accessory/adjunct; Typical site of service: outpatient prosthetics clinic or orthotics/prosthetics facility.

    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 patient with a transtibial (below-knee) amputation presents to a prosthetics clinic for fitting and routine maintenance of a prosthetic limb. The clinician provides a L8400 prosthetic sheath (below knee, each) as part of the socket interface system to protect the residual limb skin, manage friction, and improve suspension comfort. Typical workflow: initial assessment of the residual limb and skin integrity, measurement and selection of sheath size and material, documentation of limb status and prior prosthetic components, application or delivery of the sheath with patient education on wear schedule and skin inspection, and billing with appropriate modifiers to indicate laterality, third-party requirements, or special circumstances. Typical site of service is an outpatient prosthetics/orthotics clinic, rehabilitation facility, or durable medical equipment supplier operating in an ambulatory setting. A common patient scenario is a veteran or older adult with vascular or traumatic amputation who needs periodic replacement of the prosthetic sheath for hygiene, wear, or size change after limb volume fluctuations.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic(s) management and training; initial deviceUsed when training the patient in use and care of the prosthetic sheath as part of donning/doffing and skin inspection
    97761Prosthetic training, upper and/or lower extremity, initialUsed for gait training and functional prosthetic use after sheath fitting when billed separately
    99070Supplies and materials (eg., dressing, device), noncoveredUsed when small additional supplies related to sheath provision are supplied and separately billable
    L4360Insert, prosthesis, gel liner, below-kneeCommonly provided alongside a sheath as part of the socket interface system
    L5621Sock, prosthetic, wool pile, below-knee, per plyOften used in combination for residual limb volume management and cushioning

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    27Modifier 27 indicates a separate, subsequent outpatient hospital E/M service provided to the same patient on the same date by a different provider in a hospital outpatient setting. It is a…- Use modifier -27 on facility (hospital outpatient/ambulatory service center) claims to report a subsequent, separate, and distinct outpatient E/M service provided to the same patient on the same…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    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…
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    246ZB0600XBiostatiscianNone
    1223P0106XOral and Maxillofacial Pathology DentistryThe specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and m…
    261QE0002XEmergency Care Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    1835C0207XCompounded Sterile Preparations PharmacistA licensed pharmacist who has demonstrated specialized knowledge and skill to ensure that sterile preparations meet the clinical needs of patients, sa…

    Related ICD-10-CM Codes

    20 rows

    ICD-10-CM CodeDescription
    E10.621Type 1 diabetes mellitus with foot ulcer
    E11.621Type 2 diabetes mellitus with foot ulcer
    G54.4Lumbosacral root disorders, not elsewhere classified
    G54.6Phantom limb syndrome with pain
    G62.9Polyneuropathy, unspecified
    I70.235Atherosclerosis of native arteries of right leg with ulceration of other part of foot
    L97.423Non-pressure chronic ulcer of left heel and midfoot with necrosis of muscle
    L97.429Non-pressure chronic ulcer of left heel and midfoot with unspecified severity
    L97.523Non-pressure chronic ulcer of other part of left foot with necrosis of muscle
    L97.524Non-pressure chronic ulcer of other part of left foot with necrosis of bone

    Showing 1–10 of 20

    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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