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See a sample rate comparisonHCPCS L1940 Fee Schedule
Last Verified: October 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), plastic or other material, custom-fabricated
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Ankle-foot Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $598.47 median of the 7 states in the free preview · View Medicaid rates for L1940 |
National average reimbursement for HCPCS L1940 by major payers:
$485.66
$337.21
$369.99
$693.01
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HCPCS L1940
5 of 25 sample ratesHigher to lower in this preview
Emory Healthcare
Emory University
$864.33Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$371.29Published rateMichael Koch
Chestatee Pathology Associates PC
$300.47Published rateAmy Moore
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$277.95Published rateDevon Daney
Aztec Urgent Care LLC
$256.98Published rate
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See a sample payer proposalHCPCS L1940 vs. Other Ankle-foot Orthotics Codes
The HCPCS L1940 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 L1940 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 |
|---|---|---|
| L1932-HCPCS | Moderate | Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1940-HCPCS | Moderate | Ankle foot orthosis (AFO), plastic or other material, custom-fabricated |
| L1945-HCPCS | High | Ankle foot orthosis (AFO), plastic, rigid anterior tibial section (floor reaction), custom-fabricated |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L1940. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1940 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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