HCPCS L1310 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Orthotic Procedures and services • Other Scoliosis and Spinal Orthotics and Procedures |
| Common Place of Service | |
| Common Modifiers | |
| Complexity Level | High |
National average reimbursement for HCPCS L1310 by major payers:

$1,824.18

$1,165.55

$1,222.48

$2,552.85
| 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 L1310 | ||||||
United | L1310 | $945.92 | 1851400485 - GEORGE HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | L1310 | $966.08 | 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 | L1310 | $966.08 | 1013553197 - AMY MOORE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Acute Care Nurse Practitioner (363LA2100X) |
United | L1310 | $966.08 | 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 | L1310 | $966.08 | 1306540380 - KARLIE RYAN | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | L1310 | $1152.06 | 1619040284 - QUEST DIAGNOSTICS VENTURE LLC | 232933949 | PA | Clinical Medical Laboratory (291U00000X) |
United | L1310 | $1178.54 | 1366479099 - UNILAB CORPORATION, QUEST DIAGNOSTICS CLINICAL LAB | 710897031 | CA | Clinical Medical Laboratory (291U00000X) |
United | L1310 | $1178.54 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 710897031 | TN | General Acute Care Hospital (282N00000X) |
United | L1310 | $2581.94 | 1619061769 - ANNA JAQUES HOSPITAL | 42104338 - (MA) ANNA JAQUES HOSPITAL | MA | Psychiatric Hospital Unit (273R00000X) |
United | L1310 | $3761.98 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L1310 | $3761.98 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L1310 | $841.03 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L1310 | $1152.06 | 1750358297 - CITY OF HOPE NATIONAL MEDICAL CENTER | 951683875 - CITY OF HOPE NATIONAL MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | L1310 | $1152.06 | 1174671044 - ALBANY GENERAL HOSPITAL, SAMARITAN EVERGREEN HOSPICE | 930110095 - ALBANY GENERAL HOSPITAL | OR | Community Based Hospice Care Agency (251G00000X) |
United | L1310 | $1178.54 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 382084239 - QUEST DIAGNOSTICS CLINICAL LABORATORIES, INC. | TN | 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 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.
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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