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See a sample rate comparisonHCPCS L1920 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.
Ankle foot orthosis (AFO), single upright with static or adjustable stop (phelps or perlstein type), custom-fabricated
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Ankle-foot Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L1920 |
National average reimbursement for HCPCS L1920 by major payers:
$395.75
$231.89
$248.88
$573.16
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HCPCS L1920
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$565.21Published rateIrwin County Hospital
$266.38Published rateEmory Healthcare
Cardiac Arrhythmia Institute
$196.49Published rateSt. Francis Radiologists, LLC
$188.28Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$148.22Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L1920 vs. Other Ankle-foot Orthotics Codes
The HCPCS L1920 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 L1920 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 |
|---|---|---|
| L1910-HCPCS | Moderate | Ankle foot orthosis (AFO), posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment |
| L1920-HCPCS | Moderate | Ankle foot orthosis (AFO), single upright with static or adjustable stop (phelps or perlstein type), custom-fabricated |
| L1930-HCPCS | Moderate | Ankle foot orthosis (AFO), plastic or other material, 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 L1920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1920 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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