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See a sample rate comparisonHCPCS L1951 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, spiral, (institute of rehabilitative medicine type), plastic or other material, 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 Ankle-foot Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $927.82 median of the 6 states in the free preview · View Medicaid rates for L1951 |
National average reimbursement for HCPCS L1951 by major payers:
$817.52
$540.75
$612.67
$1,206.64
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HCPCS L1951
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$1,717.60Published rateTift Regional Health System, Inc., Southwell Medical
Tift Regional Health System Inc
$688.09Published rateNavicent Health Oconee, LLC, Navicent Health Baldwin
Navicent Health Oconee LLC
$460.85Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$441.85Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$338.36Published rate
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See a sample payer proposalHCPCS L1951 vs. Other Ankle-foot Orthotics Codes
The HCPCS L1951 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 L1951 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 |
|---|---|---|
| L1950-HCPCS | Moderate | Ankle foot orthosis (AFO), spiral, (institute of rehabilitative medicine type), plastic, custom-fabricated |
| L1951-HCPCS | Moderate | Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1960-HCPCS | Moderate | Ankle foot orthosis (AFO), posterior solid ankle, plastic, 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 L1951. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L1951 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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