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See a sample rate comparisonHCPCS L2265 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.
Addition to lower extremity, long tongue stirrup
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Additions, Lower Extremity Orthotics |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L2265 |
National average reimbursement for HCPCS L2265 by major payers:
$122.99
$79.07
$86.26
$190.53
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HCPCS L2265
5 of 25 sample ratesHigher to lower in this preview
City Of Hope National Medical Center
$880.00Published rateChu Chen
$308.89Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$93.52Published rateNortheast Georgia Medical Center, Inc.
Gainesville Radiology Group
$66.19Published rateProfessional Resources Management Of Rabun, LLC, Mountain Lakes Medical Center
$57.61Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L2265 vs. Other Additions, Lower Extremity Orthotics Codes
The HCPCS L2265 code is part of the Orthotic Procedures and services services used for Additions, Lower Extremity 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 L2265 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 |
|---|---|---|
| L2260-HCPCS | Moderate | Addition to lower extremity, reinforced solid stirrup (Scott-Craig type) |
| L2265-HCPCS | Low | Addition to lower extremity, long tongue stirrup |
| L2270-HCPCS | Low | Addition to lower extremity, varus/valgus correction ('T') strap, padded/lined or malleolus pad |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2265. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2265 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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