Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS L1010 Fee Schedule
Last Verified: September 2026
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.
Addition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, axilla sling
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Scoliosis Orthotic Devices |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L1010 |
National average reimbursement for HCPCS L1010 by major payers:
$74.54
$46.10
$51.70
$118.36
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS L1010.
HCPCS L1010
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$152.63Published rateAtlanta Vamc
$57.72Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$43.34Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$40.68Published rateNortheast Georgia Medical Center, Inc.
Gainesville Radiology Group
$37.72Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS L1010 vs. Other Scoliosis Orthotic Devices Codes
The HCPCS L1010 code is part of the Orthotic Procedures and services services used for Scoliosis Orthotic Devices. 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 L1010 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 |
|---|---|---|
| L1005-HCPCS | High | Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment |
| L1010-HCPCS | Low | Addition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, axilla sling |
| L1020-HCPCS | Low | Addition to Cervical-thoracic-lumbar-sacral orthosis (CTLSO) or scoliosis orthosis, kyphosis pad |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1010 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS L1010) and we'll show you how you compare in 15 minutes or less.