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See a sample rate comparisonHCPCS L1685 Fee Schedule
Last Verified: October 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.
Hip orthosis (HO), abduction control of hip joint, postoperative hip abduction type, custom fabricated
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Hip Orthotics |
| Complexity Level | High |
| Medicaid Fee Schedule | $1,353.46 median of the 8 states in the free preview · View Medicaid rates for L1685 |
National average reimbursement for HCPCS L1685 by major payers:
$1,243.41
$807.20
$884.47
$1,589.54
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HCPCS L1685
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$3,268.43Published rateChristopher Chambers
Cooperative Healthcare Services Inc
$1,117.55Published rateQuest Diagnostics LLC Il
$1,116.00Published rateQuest Diagnostics LLC Il
$893.03Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$668.53Published rate
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See a sample payer proposalHCPCS L1685 vs. Other Hip Orthotics Codes
The HCPCS L1685 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 L1685 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 |
|---|---|---|
| L1680-HCPCS | High | Hip orthosis (HO), abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (Rancho hip action type), custom fabricated |
| L1685-HCPCS | High | Hip orthosis (HO), abduction control of hip joint, postoperative hip abduction type, custom fabricated |
| L1686-HCPCS | Moderate | Hip orthosis (HO), abduction control of hip joint, postoperative hip abduction 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 L1685. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1685 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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