On August 18, the Centers for Medicare & Medicaid Services (CMS) dropped its quarterly refresh of the HCPCS Level II code set. Mark your calendars, because these changes go live on October 1.
Here’s the breakdown of what’s coming:
- 88 new codes
- 14 codes getting deleted
- 11 long descriptor changes
- 5 codes with payment changes
- 1 code with an administrative field tweak
Quick refresher for anyone who needs it: HCPCS Level II codes exist mainly to cover products, supplies, and services that don’t fall under the AMA’s CPT® code set. If you missed the last quarterly cycle, you can catch up on the HCPCS Level II code changes effective April 1, 2026 too.
Where Do New Codes Come From?
Here’s something a lot of people don’t realize — anyone can actually request a change to the HCPCS Level II code set. CMS holds public meetings twice a year where applicants and other stakeholders get the chance to make their case for specific coding requests. Out of the 88 new codes in this update, 15 came directly from individuals or manufacturers who submitted requests that CMS ultimately approved.
Here’s the full list:
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. (For more on getting these claims paid correctly, check out these wound care coding and documentation tips.)
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 comes in around $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 roughly $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. For 2026, the average capped rental non-rural fee schedule amount lands around $314.22 for months one through three, then drops to about $235.66 for months four through 13 — adding up to $3,299.26 total after 13 months of continuous use.
E2403 External ocular negative pressure pump, electric describes the FSYX™ Ocular Pressure Adjusting Pump, used to treat glaucoma in patients whose intraocular pressure measures above 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 was created for the CoreTech® sternocostal orthosis — a back brace designed for the nonoperative management of patients with costochondritis and other chest wall conditions that call for targeted sternocostal stabilization.
L1972 Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, off-the shelf covers a prefabricated, off-the-shelf ankle foot orthosis that includes an ankle joint. This addition also triggered a change to an existing 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 now revised to specifically 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’s external pulse generator. This one bundles in the external replacement components too, like the surface electrode pads. Because of that overlap, the older code L8696 is being retired as of October 1. (Coders working with these devices may also want to bookmark this phrenic nerve stimulation system services coding guide.)
Q4207 Carbon life, per square centimeter (add-on, list separately in addition to primary procedure) describes Carbon Life, an allograft wound covering meant to shield wounds from the surrounding environment.
Q4223 Dermabind sl optic, per square centimeter (add-on, list separately in addition to primary procedure) describes DermaBlind SL Optic™, built for use as an ocular wound covering in both 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 used as a barrier and protective cover for acute and chronic wounds.
Since so many of these new additions are skin substitute and wound covering products, it’s worth keeping an eye on the 2026 Medicare CTP rule changes for skin substitute reimbursement, which directly affect how these Q codes get paid.
A Few Codes Got a Facelift
Of the 11 codes with updated long descriptors, three exist because a stakeholder originally asked for brand-new codes altogether. Instead of creating separate codes just for Amoena Adapt Air™, CMS decided to broaden the language in L8030 and L8031 so they now cover “any type” of breast prosthesis, with or without adhesive. The average 2026 fee schedule amount for these two codes sits at $430.74.
CMS took the same approach with L8035, revising it to cover “any type” of custom breast prosthesis — which includes Amoena Custom Adapt Air™. That code carries an average 2026 fee schedule amount of $4,505.38.
And Everything Else
The J code section, which covers drug reporting, isn’t sitting still either — this update brings a mix of new additions, some discontinued codes, and a handful of descriptor revisions. On the payment side, the changes apply to A2040 through A2043, plus A2045. And rounding things out, E0150 Combination wheeled walker with seat and transport chair, folding, adjustable or fixed height picks up an administrative field change.
For coders who want the bigger picture heading into next year, it’s also worth checking out what’s coming with the FY 2027 ICD-10-CM code updates and the FY 2027 ICD-10-PCS updates, both effective the same October 1 date as this HCPCS release.
