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See a sample rate comparisonHCPCS L1820 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.
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Knee Orthotics |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L1820 |
National average reimbursement for HCPCS L1820 by major payers:
$129.26
$87.55
$105.26
$193.24
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HCPCS L1820
5 of 25 sample ratesHigher to lower in this preview
Blue Ridge Orthopaedic Associates PC, Industrial Health
Blue Ridge Orthopaedic Associates, P.C.
$178.02Published rateJacqueline Morris
Blue Ridge Orthopaedic Associates, P.C.
$172.28Published rateMichael Poss
Blue Ridge Orthopaedic Associates, P.C.
$172.28Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$89.62Published rateMichael Guillette
Aztec Urgent Care LLC
$67.37Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L1820 vs. Other Knee Orthotics Codes
The HCPCS L1820 code is part of the Orthotic Procedures and services services used for Knee 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 L1820 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 |
|---|---|---|
| L1812-HCPCS | Low | Knee orthosis (KO), elastic with joints, prefabricated, off-the-shelf |
| L1820-HCPCS | Low | Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1830-HCPCS | Low | Knee orthosis (KO), immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1820 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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