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See a sample rate comparisonHCPCS L2405 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 knee joint, drop lock, each
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Orthotic Additions to Knee Joints |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L2405 |
National average reimbursement for HCPCS L2405 by major payers:
$85.31
$56.13
$62.06
$123.55
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HCPCS L2405
5 of 25 sample ratesHigher to lower in this preview
Emory University Hospital
Emory University
$178.33Published rateTift Regional Health System Inc., Tift Regional Medical Center
Tift Regional Health System Inc
$71.44Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$53.27Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$45.88Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
$32.66Published rate
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See a sample payer proposalHCPCS L2405 vs. Other Orthotic Additions to Knee Joints Codes
The HCPCS L2405 code is part of the Orthotic Procedures and services services used for Orthotic Additions to Knee Joints. 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 L2405 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 |
|---|---|---|
| L2397-HCPCS | Low | Addition to lower extremity orthosis, suspension sleeve |
| L2405-HCPCS | Low | Addition to knee joint, drop lock, each |
| L2415-HCPCS | Low | Addition to knee lock with integrated release mechanism ( bail, cable, or equal), any material, each joint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2405. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2405 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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