HCPCS L0641 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 • Lumbar Orthotics Sagittal Control |
| Complexity Level | Low |
National average reimbursement for HCPCS L0641 by major payers:
$45.54
$50.83
$45.51
$71.00
| 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 L0641 | ||||||
United | L0641 | $46.95 | 1578587515 - JILL CUNNINGHAM | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | L0641 | $46.95 | 1609657287 - ASHLEY PARMENTIER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | L0641 | $30.47 | 1003543711 - AMELA THOMPSON | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | L0641 | $46.95 | 1861456444 - SCOTT PEPLINSKI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | L0641 | $30.47 | 1508252784 - MOHAMMAD-ALI YAZDANI ABYANEH | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Dermatology Physician (207N00000X) |
United | L0641 | $30.47 | 1306067517 - ROHIN MEHTA | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Anatomic Pathology Physician (207ZP0101X) |
United | L0641 | $30.47 | 1891784807 - RAMESH CHERUKURI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Anesthesiology Physician (207L00000X) |
United | L0641 | $30.47 | 1528054368 - TATYANA ANTONEVICH | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Pulmonary Disease Physician (207RP1001X) |
United | L0641 | $30.47 | 1407840614 - MARIA GESUALDO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | L0641 | $46.95 | 1063106441 - ANDREA MOEHRINGER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | L0641 | $77.90 | 1205833241 - CLHG-WINN, LLC, WINN PARISH MEDICAL CENTER | 813465517 | LA | General Acute Care Hospital (282N00000X) |
United | L0641 | $30.47 | 1992793137 - KAREN FLICK | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Nurse Practitioner (363L00000X) |
United | L0641 | $91.65 | 1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2 | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | L0641 | $91.65 | 1326485749 - SOUTHERN REGIONAL MEDICAL CORPORATION, LEONARD J. CHABERT MEDICAL CENTER | 462743282 | LA | General Acute Care Hospital (282N00000X) |
United | L0641 | $89.26 | 1104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC | 208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C. | LA | General Acute Care Hospital (282N00000X) |
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 L0641 vs. Other Lumbar Orthotics Sagittal Control Codes
The HCPCS L0641 code is part of the Orthotic Procedures and services services used for Lumbar Orthotics Sagittal Control. 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 L0641 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 |
|---|---|---|
| L0640-HCPCS | High | Lumbar-sacral orthosis (LSO), sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to T-9 vertebra, anterior extends from symphysis pubis to xiphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated |
| L0641-HCPCS | Low | Lumbar orthosis (LO), sagittal control, with rigid posterior panel(s), posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0642-HCPCS | Moderate | Lumbar orthosis (LO), sagittal control, with rigid anterior and posterior panels, posterior extends from L-1 to below L-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L0641. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L0641 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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