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See a sample rate comparisonHCPCS L2397 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 orthosis, suspension sleeve
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Additions, Lower Extremity Orthotics |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L2397 |
National average reimbursement for HCPCS L2397 by major payers:
$113.28
$75.11
$83.20
$173.55
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HCPCS L2397
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$189.49Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$63.11Published rateJason Nemitz
Orthopedic Specialists Of Sw Florida PA
$62.68Published rateJason Cullen
Orthopedic Specialists Of Sw Florida PA
$62.68Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$43.91Published rate
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See a sample payer proposalHCPCS L2397 vs. Other Additions, Lower Extremity Orthotics Codes
The HCPCS L2397 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 L2397 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 |
|---|---|---|
| L2395-HCPCS | Low | Addition to lower extremity, offset knee joint, heavy duty, each joint |
| L2397-HCPCS | Low | Addition to lower extremity orthosis, suspension sleeve |
| L2405-HCPCS | Low | Addition to knee joint, drop lock, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2397. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2397 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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