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See a sample rate comparisonHCPCS L0859 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Cervical Halo Procedures |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L0859 |
National average reimbursement for HCPCS L0859 by major payers:
$1,193.86
$789.24
$866.83
$1,153.69
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HCPCS L0859
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$2,317.11Published rateVictoria Lewis-Holland
$1,031.40Published rateAlicia Encinas
Miguel A Arenas Md PC
$684.70Published rateMichael Guillette
Aztec Urgent Care LLC
$633.05Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$456.47Published rate
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See a sample payer proposalHCPCS L0859 vs. Other Cervical Halo Procedures Codes
The HCPCS L0859 code is part of the Orthotic Procedures and services services used for Cervical Halo Procedures. 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 L0859 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 |
|---|---|---|
| L0830-HCPCS | High | Halo procedure, cervical halo incorporated into Milwaukee type orthosis |
| L0859-HCPCS | High | Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material |
| L0861-HCPCS | Moderate | Addition to halo procedure, replacement liner/interface material |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L0859. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L0859 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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