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HCPCS L2425 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, disc or dial lock for adjustable knee flexion, each joint
Key FactDetail
Service Type

Orthotic Procedures and services

Orthotic Additions to Knee Joints

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for L2425

National average reimbursement for HCPCS L2425 by major payers:

bcbs

$143.23

uhc

$92.33

aetna

$101.09

cigna

$203.64

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS L2425.

HCPCS L2425
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $308.35Published rate
  2. Quest Diagnostics Venture LLC

    PAClinical Medical LaboratoryNPI 1619040284Tax ID 23-2933949

    $136.66Published rate
  3. Progressive Emergency Physicians PLLC

    NYEmergency Medicine PhysicianNPI 1588098172Tax ID 46-3316332

    $86.70Published rate
  4. Chi Memorial Hospital

    Chi Memorial Hospital - Georgia

    GAGeneral Acute Care HospitalNPI 1356860621Tax ID 82-2748395

    $76.97Published rate
  5. Wildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital

    Wildwood Sanitarium Incorporated

    GAGeneral Acute Care HospitalNPI 1235153883Tax ID 58-6039864

    $57.75Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS L2425 vs. Other Orthotic Additions to Knee Joints Codes

The HCPCS L2425 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 L2425 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.

CodeComplexityDescription
L2415-HCPCSLowAddition to knee lock with integrated release mechanism ( bail, cable, or equal), any material, each joint
L2425-HCPCSLowAddition to knee joint, disc or dial lock for adjustable knee flexion, each joint
L2430-HCPCSLowAddition to knee joint, ratchet lock for active and progressive knee extension, 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 L2425. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L2425 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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