CMS Finalizes October 2026 HCPCS Level II Changes
- By Renee Dustman
- In Billing
- August 21, 2026
- No Comments
Aug. 18, the Centers for Medicare & Medicaid Services (CMS) posted a quarterly update to the HCPCS Level II code set. The changes are effective Oct. 1.
The October 2026 update includes:
- 88 new codes
- 14 deleted codes
- 11 long descriptor changes
- 5 codes with payment changes
- 1 code with an administrative field change
HCPCS Level II codes are used primarily to identify products, supplies, and services not included in the American Medical Association’s CPT® code set.
New Codes by Request
Anyone may submit a request to modify the HCPCS Level II code set. CMS conducts biannual HCPCS Level II public meetings at which time applicants and other stakeholders may present additional information about specific coding requests. Among the 88 new codes, 15 were requested by individuals or manufacturers and finalized by CMS.
A2046 Dermisphere hdrt, per square centimeter (add-on, list separately in addition to primary procedure) was finalized for the DermiSphere™ hDRT composite biodegradable wound dressing.
A2047 Lacertamatrix, per square centimeter (add-on, list separately in addition to primary procedure) identifies LacertaMatrix — a sterile, single-use, collagen matrix for wound management.
A2048 Puraply mz, per milligram describes the PuraPly® MZ wound dressing.
A2049 Theracor, per square centimeter (add-on, list separately in addition to primary procedure) describes Theracor™, a medical device indicated for acute and chronic wound management.
A2050 Fibrillar collagen wound dressing, per milligram is a single-use, advanced fibrillar collagen matrix intended for the management of moderately- to heavily-exudated wounds and to control minor bleeding. Medicare payment is contractor-based.
A4228 Supplies for maintenance of non-insulin, device-drug combination infusion catheter, per week identifies supplies for a device-drug combination infusion pump such as the VYAFUSER™ pump. The “per week” fee is based on 2.5 units of HCPCS Level II code A4222 to account for changing the supplies every three days. The average non-rural fee schedule amount is approximately $124.54.
A6614 Supplies and accessories for use with an external ocular negative pressure pump, any type, per month describes the FSYX™ Ocular Pressure Adjusting Pump Goggles. The 2026 fee schedule amount is approximately $167.99 per unit.
E0788 Ambulatory infusion pump, specific device-drug combination, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient identifies external infusion pumps for unique device-drug combinations, such as the VYAFUSER™ pump. The 2026 average capped rental non-rural fee schedule amount will be approximately $314.22 for months one through three and approximately $235.66 for months four through 13, for a total of $3,299.26 after 13 months of continuous use.
E2403 External ocular negative pressure pump, electric describes the FSYX™ Ocular Pressure Adjusting Pump, indicated for the treatment of glaucoma in individuals with measured intraocular pressure greater than 21 mmHg.
L1330 Thoracic orthosis, sternal and/or sternocostal compression, may include anterior and/or posterior pads, panels, with or without frame, prefabricated, includes fitting and adjustment is created to describe CoreTech® sternocostal orthosis — a back brace intended for nonoperative management of individuals with costochondritis and related chest wall disorders requiring targeted sternocostal stabilization.
L1972 Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf describes a prefabricated, off-the-shelf ankle foot orthosis with an ankle joint. In creating this code, L1971 Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise is revised to describe a custom-fitted prefabricated ankle foot orthosis with an ankle joint.
L8697 External accessory for use with implantable phrenic nerve stimulation device, replacement, each describes the NeuRx® Diaphragm Pacing System external pulse generator. The external replacement components associated with the device — such as the surface electrode pads — are bundled into this code. Because of the overlap, existing code L8696 is discontinued effective Oct. 1.
Q4207 Carbon life, per square centimeter (add-on, list separately in addition to primary procedure) describes Carbon Life, an allograft wound covering designed to offer protection from the surrounding environment.
Q4223 Dermabind sl optic, per square centimeter (add-on, list separately in addition to primary procedure) describes DermaBlind SL Optic™, intended for use as an ocular wound covering for acute and chronic eye wounds.
Q4243 Amchomatrix, per square centimeter (add-on, list separately in addition to primary procedure) describes AmchoMatrix — an allograft wound covering intended for use as a barrier and cover for acute and chronic wounds.
Revised Codes
Of the 11 codes with long descriptor changes, three were the result of a stakeholder’s request for new codes.
Instead of creating new codes specifically describing Amoena Adapt Air™, CMS is revising the descriptors for L8030 and L8031 to indicate that the existing codes describe “any type” of breast prosthesis with or without adhesive. The average 2026 fee schedule amount for these codes is $430.74. Likewise, CMS is revising L8035 to indicate that the code describes “any type” of custom breast prosthesis, including Amoena Custom Adapt Air™. The average 2026 fee schedule amount for this code is $4,505.38.
A Mixed Bag
Also in the update, the J code section for reporting drugs sees some additions, some discontinuations, and some descriptor revisions. The payment change applies to A2040-A2043, A2045. And the code with an administrative field change is E0150 Combination wheeled walker with seat and transport chair, folding, adjustable or fixed height.
The official October 2026 update files to the HCPCS Level II code set are available for download at CMS.gov.
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