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HCPCS L1310 Fee Schedule

Last Verified: November 2025

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.

Other scoliosis procedure, post-operative body jacket
Key FactDetail
Service Type

Orthotic Procedures and services

Other Scoliosis and Spinal Orthotics and Procedures

Common Place of Service
Common Modifiers
Complexity LevelHigh

National average reimbursement for HCPCS L1310 by major payers:

bcbs

$1,824.18

uhc

$1,165.55

aetna

$1,222.48

cigna

$2,552.85

Preview provider-level rates for...
For billing codeHCPCS L1310
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L1310

United
L1310$945.921851400485 - GEORGE HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L1310$966.081790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L1310$966.081013553197 - AMY MOORE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALAcute Care Nurse Practitioner (363LA2100X)
United
L1310$966.081790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L1310$966.081306540380 - KARLIE RYAN451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALFamily Nurse Practitioner (363LF0000X)
United
L1310$1152.061619040284 - QUEST DIAGNOSTICS VENTURE LLC232933949PAClinical Medical Laboratory (291U00000X)
United
L1310$1178.541366479099 - UNILAB CORPORATION, QUEST DIAGNOSTICS CLINICAL LAB710897031CAClinical Medical Laboratory (291U00000X)
United
L1310$1178.541023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER710897031TNGeneral Acute Care Hospital (282N00000X)
United
L1310$2581.941619061769 - ANNA JAQUES HOSPITAL42104338 - (MA) ANNA JAQUES HOSPITALMAPsychiatric Hospital Unit (273R00000X)
United
L1310$3761.981073502985 - CHU CHEN42484572MAPediatrics Physician (208000000X)
United
L1310$3761.981073502985 - CHU CHEN42484572MAPediatrics Physician (208000000X)
United
L1310$841.031235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER586002922GARural Acute Care Hospital (282NR1301X)
United
L1310$1152.061750358297 - CITY OF HOPE NATIONAL MEDICAL CENTER951683875 - CITY OF HOPE NATIONAL MEDICAL CENTERCAGeneral Acute Care Hospital (282N00000X)
United
L1310$1152.061174671044 - ALBANY GENERAL HOSPITAL, SAMARITAN EVERGREEN HOSPICE930110095 - ALBANY GENERAL HOSPITALORCommunity Based Hospice Care Agency (251G00000X)
United
L1310$1178.541023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER382084239 - QUEST DIAGNOSTICS CLINICAL LABORATORIES, INC.TNGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS L1310 vs. Other Other Scoliosis and Spinal Orthotics and Procedures Codes

The HCPCS L1310 code is part of the Orthotic Procedures and services services used for Other Scoliosis and Spinal Orthotics and 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 L1310 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.

CodeComplexityDescription
L1300HighOther scoliosis procedure, body jacket molded to patient model
L1310HighOther scoliosis procedure, post-operative body jacket
L1499HighSpinal orthosis, not otherwise specified

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1310. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L1310 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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