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    v1.0.28
    OpenPayerBilling CodesProsthetic ProceduresHCPCS hcpcs-l8485-prosthetic-sock-upper-limb-fitting-single-ply
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    HCPCS Level II L8485: Prosthetic Sock, Single Ply, Upper Limb

    HCPCS Level II code L8485 describes a single-ply prosthetic sock used for fitting of an upper limb prosthesis; the service is a prosthetic soft-liner/accessory provision performed in an orthotics/prosthetics clinic or similar ambulatory setting to assist with socket fit and comfort for an upper extremity prosthesis.

    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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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A patient with an upper-limb amputation presents to a prosthetics clinic for fitting of a single-ply prosthetic sock to be used with a transradial or transhumeral prosthetic socket. Typical patients include recent postoperative amputees during early prosthetic fitting or established prosthesis users needing an additional or replacement L8485 sock for volume management and comfort. The clinical workflow: intake and review of amputation level and residual-limb measurements, inspection of skin integrity, selection of the appropriate single-ply sock size and material, trial fitting inside the prosthetic socket, minor adjustments for pressure distribution, documentation of sock quantity and fit, and issuance with education on wear time and skin monitoring. Billing occurs under HCPCS L8485 for each sock supplied; payer policies may require proof of medical necessity (e.g., residual-limb volume fluctuation, skin protection) and appropriate diagnosis linkage.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic management and training, upper extremity; initial fit of orthosis, subsequent training and adjustment(s)Used when initial fitting and patient training for an upper-limb orthotic/prosthetic device accompany sock fitting
    97763Orthotic management and training, upper extremity; follow-up, routine adjustmentsPerformed for routine adjustments of the prosthetic socket where sock use alters fit
    99354Prolonged physician service (face-to-face) - demonstration/education may be billed when extended counseling occursMay be used if extended physician-level education or assessment is documented during complex fittings
    99499Unlisted evaluation and management serviceRarely used for atypical provider work related to complex prosthetic fittings when no specific code exists
    99070Supplies and materials (not included in other codes)May be used by some payers to report additional non-covered supplies provided at the time of fitting

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    59Modifier 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…
    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…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    213E00000XPodiatristA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that l…
    207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the labora…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    126800000XDental AssistantAn individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care se…
    207RE0101XEndocrinology, Diabetes & Metabolism PhysicianAn internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with …
    103TF0000XFamily PsychologistA psychologist whose specialty is founded on principles of systems theory with the interpersonal system of the family the focus of assessment, interve…
    163WP0809XAdult Psychiatric/Mental Health Registered NurseNursing Service Providers · Registered Nurse

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    B86Scabies
    E11.620Type 2 diabetes mellitus with diabetic dermatitis
    G54.1Lumbosacral plexus disorders
    G56.41Causalgia of right upper limb
    M21.619Bunion of unspecified foot
    M24.271Disorder of ligament, right ankle
    M24.272Disorder of ligament, left ankle
    M25.511Pain in right shoulder
    M25.512Pain in left shoulder
    M79.641Pain in right hand

    Showing 1–10 of 22

    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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