HCPCS L1900 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Orthotic Procedures and services • Ankle-foot Orthotics |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L1900 by major payers:
$285.84
$179.86
$198.48
$402.14
| 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 L1900 | ||||||
United | L1900 | $215.00 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | L1900 | $654.54 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L1900 | $147.99 | 1326028978 - CHATUGE REGIONAL HOSPITAL INC | 582513901 - CHATUGE REGIONAL HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | L1900 | $171.82 | 1417554528 - KECK MEDICAL CENTER OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | L1900 | $125.12 | 1417554528 - KECK MEDICAL CENTER OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | L1900 | $624.79 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L1900 | $376.97 | 1689063554 - ATL COLORECTAL SURGERY | 205040872 - (GA) ATL COLORECTAL SURGERY | GA | General Acute Care Hospital (282N00000X) |
United | L1900 | $157.16 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 582155150 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L1900 | $272.60 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L1900 | $154.35 | 1245248624 - HOSPITAL AUTHORITY OF BEN HILL, DORMINY MEDICAL CENTER | 581157005 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L1900 | $222.77 | 1639157431 - PHOEBE WORTH MEDICAL CENTER, INC, PHOEBE WORTH MEDICAL CENTER, INC | 383647394 - (GA) PHOEBE WORTH MEDICAL CENTER INC | GA | Critical Access Hospital (282NC0060X) |
United | L1900 | $151.61 | 1427055821 - NORTHEAST GEORGIA MEDICAL CENTER, INC. | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
United | L1900 | $147.99 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | L1900 | $125.12 | 1366479099 - UNILAB CORPORATION, QUEST DIAGNOSTICS CLINICAL LAB | 710897031 | CA | Clinical Medical Laboratory (291U00000X) |
United | L1900 | $164.26 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
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 L1900 vs. Other Ankle-foot Orthotics Codes
The HCPCS L1900 code is part of the Orthotic Procedures and services services used for Ankle-foot 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 L1900 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 |
|---|---|---|
| L1860-HCPCS | High | Knee orthosis (KO), modification of supracondylar prosthetic socket, custom-fabricated (SK) |
| L1900-HCPCS | Moderate | Ankle foot orthosis (AFO), spring wire, dorsiflexion assist calf band, custom-fabricated |
| L1902-HCPCS | Low | Ankle orthosis, ankle gauntlet or similar, with or without joints, 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 L1900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1900 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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