External Breast Prostheses
National · Effective Apr 1, 2025
1 active Medicare policy lists L8033, and 3 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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National · Effective Apr 1, 2025
3 policies from 3 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of L8033 |
|---|---|---|
| Breast Reconstruction Following Mastectomy or Lumpectomy | Apr 15, 2026 | Covered |
| Policy | Effective | Status of L8033 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of L8033 |
|---|---|---|
| Prosthetics | Oct 7, 2025 | Covered with conditions |