HCPCS L0174 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Orthotic Procedures and services • Cervical Orthotics |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L0174 by major payers:
$258.93
$180.61
$204.57
$395.91
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L0174 | ||||||
United | L0174 | $154.39 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | L0174 | $154.39 | 1013553197 - AMY MOORE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Acute Care Nurse Practitioner (363LA2100X) |
United | L0174 | $154.39 | 1548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC | 232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.C | PA | Clinical Pathology/Laboratory Medicine Physician (207ZP0105X) |
United | L0174 | $241.77 | 1821098286 - TOURO INFIRMARY | 720423659 - (LA) TOURO INFIRMARY | LA | General Acute Care Hospital (282N00000X) |
United | L0174 | $412.64 | 1104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC | 208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | L0174 | $404.23 | 1740476696 - PEGGY BROKL | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Occupational Therapist (225X00000X) |
United | L0174 | $404.23 | 1235785478 - ARIENNE KRIZENESKY | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Family Nurse Practitioner (363LF0000X) |
United | L0174 | $350.73 | 1568663920 - PROGRESSIVE ACUTE CARE AVOYELLES, LLC, AVOYELLES HOSPITAL | 813465468 | LA | General Acute Care Hospital (282N00000X) |
United | L0174 | $412.64 | 1649262791 - SABINE MEDICAL CENTER INC, SABINE MEDICAL CENTER | 262074318 | LA | General Acute Care Hospital (282N00000X) |
United | L0174 | $404.23 | 1639515281 - BENJAMIN SAVAGE | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | IL | Internal Medicine Physician (207R00000X) |
United | L0174 | $412.64 | 1093140600 - OUR LADY OF THE ANGELS HOSPITAL, INC., OUR LADY OF THE ANGELS HOSPITAL | 463123178 - (LA) OUR LADY OF THE ANGELS HOSPITAL INC | LA | General Acute Care Hospital (282N00000X) |
United | L0174 | $404.23 | 1457184970 - EMILY WACHTENDONK | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Family Nurse Practitioner (363LF0000X) |
United | L0174 | $404.23 | 1235779570 - ASHLEY FAULKS | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Family Nurse Practitioner (363LF0000X) |
United | L0174 | $404.23 | 1356382535 - THOMAS MATTIO | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurology Physician (2084N0400X) |
United | L0174 | $404.23 | 1538119649 - PHILIP YAZBAK | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurological Surgery Physician (207T00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L0174 vs. Other Cervical Orthotics Codes
The HCPCS L0174 code is part of the Orthotic Procedures and services services used for Cervical Orthotics. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS L0174 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| L0172-HCPCS | Low | Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf |
| L0174-HCPCS | Moderate | Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf |
| L0180-HCPCS | Moderate | Cervical, multiple post collar, occipital/mandibular supports, adjustable |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L0174. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L0174 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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