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See a sample rate comparisonHCPCS L1640 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.
Hip orthosis (HO), abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom-fabricated
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Hip Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L1640 |
National average reimbursement for HCPCS L1640 by major payers:
$473.34
$309.71
$330.72
$674.53
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HCPCS L1640
5 of 25 sample ratesHigher to lower in this preview
Emory Healthcare
Emory University
$877.65Published rateHamilton Medical Center, Inc.
Hamilton Medical Center Inc
$432.23Published rateMeriwether County Hospital Authority, Warm Springs Medical Center
Meriwether Healthcare, LLC D/B/A Warm Springs Medical Center
$259.33Published rateQuest Diagnostics LLC Il
$216.41Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$172.89Published rate
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See a sample payer proposalHCPCS L1640 vs. Other Hip Orthotics Codes
The HCPCS L1640 code is part of the Orthotic Procedures and services services used for Hip Orthotics. 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 L1640 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 |
|---|---|---|
| L1630-HCPCS | Low | Hip orthosis (HO), abduction control of hip joints, semi-flexible (Von Rosen type), custom-fabricated |
| L1640-HCPCS | Moderate | Hip orthosis (HO), abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom-fabricated |
| L1650-HCPCS | Moderate | Hip orthosis (HO), abduction control of hip joints, static, adjustable, (Ilfled type), prefabricated, includes fitting and adjustment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1640 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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