BAHA Hearing Aids: How Medicare Classifies and Pays for Bone-Anchored Implants

An implanted (osseointegrated) BAHA is a prosthetic device; a headband BAHA is not

Medicare's rules place an implanted (osseointegrated) BAHA on the prosthetic device side of the line. A CMS final rule published in the Federal Register, in effect January 1, 2015, lists among prosthetic devices "Osseointegrated implants, that is, devices implanted in the skull that replace the function of the middle ear and provide mechanical energy to the cochlea via a mechanical transducer." Cochlear implants and auditory brainstem implants sit in the same list.

A BAHA sound processor worn on a headband, without the implant, falls on the other side. The Medicare Benefit Policy Manual definition that the rule quotes counts as hearing aids "bone conduction devices that provide mechanical energy to the cochlea via stimulation of the scalp with amplified mechanical vibration", and the rule states: "Air conduction and non-osseointegrated bone conduction hearing aids have been in existence since 1965 and have not been covered by Medicare." The CMS October 2026 HCPCS file matches: L8692, "Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment", carries coverage code S, "Non-covered by Medicare statute", with the statute reference 1862(a)(7).

The same rule records a proposal that did not go through. CMS had proposed to further interpret the hearing aid statutory exclusion; after public comments, it decided not to finalize that proposal. The final rule instead codifies the program instructions already in section 100 of Chapter 16 of the Medicare Benefit Policy Manual. What applies today is the classification above, not the dropped proposal.

Bone conduction hearing aids in FDA rules: two device categories

The FDA draws its own line, in device law rather than in Medicare payment. Its regulation at 21 CFR 874.3302 covers bone-conduction hearing aids: "A bone-conduction hearing aid is a wearable sound-amplifying device intended to compensate for impaired hearing and that conducts sound to the inner ear through the skull." The FDA classification database files two product codes under that same regulation number, 874.3302: "Hearing Aid, Bone Conduction", product code LXB, with an implant flag of N, and "Hearing Aid, Bone Conduction, Implanted", product code MAH, with an implant flag of Y. One regulation therefore covers both a device the FDA does not record as an implant and one it does.

A separate regulation, 21 CFR 874.3340, covers the implanted kind: "An active implantable bone conduction hearing system is a prescription device consisting of an implanted transducer, implanted electronics components, and an audio processor."

These are categories for placing a device on the market. They do not say who is a candidate, how well a device works or whether a plan pays for a named model. For Medicare, the classification in the section above decides, and the headband processor code L8692 keeps coverage code S, non-covered by Medicare statute.

What you pay when Part B covers the device

Medicare.gov's prosthetic devices page sets the cost share: after you meet the Part B deductible, you pay 20% of the Medicare-approved amount. The Part B deductible is $283 in 2026.

Two more rules from the same page shape the bill:

• Part A or Part B. Either part covers a surgically implanted prosthetic device, depending on whether the surgery takes place in an inpatient or outpatient setting.
• Participating supplier. Medicare only pays for a prosthetic device from a supplier that participates in Medicare.

Hospital outpatient and ASC rates for the implant procedures

CMS sets a national rate for each procedure code in its October 2026 OPPS file, for hospital outpatient departments, and in its ASC file, for ambulatory surgery centers. The table shows both side by side, as facility rates only.

• 69714, 69716, 69719, 69729 and 69730: OPPS rate $13,116.76 (APC 5115, status indicator J1). ASC rates are $10,487.38, $10,620.42, $10,371.33, $10,615.15 and $10,238.29 in that order, each with payment indicator J8 and flagged device-intensive.
• 69717: OPPS rate $7,413.38 (APC 5114). ASC rate $5,663.31, payment indicator J8, flagged device-intensive.
• 69726, 69727 and 69728: OPPS rate $3,342.87 (APC 5113). ASC rate $1,644.87 each, payment indicator G2, not flagged device-intensive.

These are national amounts, not a hospital's or a surgery center's price.

The copayment fields in the OPPS file

The OPPS file prints copayment fields per code, and the table copies them as written. The minimum unadjusted copayment is $2,623.36 for the APC 5115 codes, $1,482.68 for 69717 and $668.58 for the APC 5113 codes.

An adjusted beneficiary copayment appears for the APC 5115 codes only, and the adjusted copayment printed for APC 5115, $1,736.00, is lower than the $2,623.36 minimum unadjusted copayment. For 69717 and the APC 5113 codes, that field is empty, and the table leaves it empty. Our ASC rows carry no copayment figure, and none is calculated for them.

State amounts for the device and its replacement parts

The CMS DMEPOS fee schedule, effective October 1, 2026, lists bone-anchored device codes with an amount per state:

• L8690, "Auditory osseointegrated device, includes all internal and external components": $5,717.38 to $6,289.09.
• L8691, "Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each": $2,069.73 to $2,276.70.
• L8693, "Auditory osseointegrated device abutment, any length, replacement only": $1,822.38 to $1,891.40.
• L8694, "Auditory osseointegrated device, transducer/actuator, replacement only, each": $1,134.98 to $1,178.01.

Texas lists $5,888.96 for L8690 and $2,131.89 for L8691; California lists $5,717.38 and $2,069.73. The top L8690 and L8691 amounts are in Puerto Rico and the U.S. Virgin Islands.

The table keeps non-zero amounts from the non-rural column only. A state without a row has no published amount for that code, which does not make the part free. L8692, the processor used without osseointegration on a headband, has no row in the October 2026 fee schedule file; the CMS HCPCS file of the same quarter gives it coverage code S, non-covered by Medicare statute.

Related pages

Cochlear implants, listed in the same prosthetic device rule, are on cochlear implant cost and does Medicare cover cochlear implants. Battery and charger codes shared with cochlear systems are on cochlear implant processor replacement cost. Conventional hearing aids are on does Medicare cover hearing aids, and CROS devices on are CROS hearing aids covered by insurance.