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See a sample rate comparisonHCPCS L2525 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Addition to lower extremity, thigh/weight bearing, ischial containment/narrow M-L brim molded to patient model
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Additions, Weight-bearing, Lower Extremities |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L2525 |
National average reimbursement for HCPCS L2525 by major payers:
$1,320.67
$845.91
$920.91
$1,633.95
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HCPCS L2525
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$3,349.50Published rateAtlanta Vamc
$1,048.42Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$880.00Published rateTattnall Hospital Company, LLC, Optim Medical Center - Tattnall
$836.15Published rateAmy Moore
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$685.11Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L2525 vs. Other Additions, Weight-bearing, Lower Extremities Codes
The HCPCS L2525 code is part of the Orthotic Procedures and services services used for Additions, Weight-bearing, Lower Extremities. 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 L2525 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 |
|---|---|---|
| L2520-HCPCS | Moderate | Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted |
| L2525-HCPCS | High | Addition to lower extremity, thigh/weight bearing, ischial containment/narrow M-L brim molded to patient model |
| L2526-HCPCS | Moderate | Addition to lower extremity, thigh/weight bearing, ischial containment/narrow M-L brim, custom fitted |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2525. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2525 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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