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See a sample rate comparisonHCPCS L2628 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, pelvic control, metal frame, reciprocating hip joint and cables
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Additions, Pelvic and/or Thoracic Control, Lower Extremities |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L2628 |
National average reimbursement for HCPCS L2628 by major payers:
$1,922.46
$1,139.97
$1,235.09
$2,237.78
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HCPCS L2628
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$4,026.37Published rateVictoria Lewis-Holland
$1,708.18Published rateUjuka Iloabuchi
Atlanta Womens Health Group, P.C.
$1,133.98Published ratePatrick Reidy
Florida Gulf Coast Ear, Nose And Throat, LLC
$976.11Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$880.00Published rate
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See a sample payer proposalHCPCS L2628 vs. Other Additions, Pelvic and/or Thoracic Control, Lower Extremities Codes
The HCPCS L2628 code is part of the Orthotic Procedures and services services used for Additions, Pelvic and/or Thoracic Control, 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 L2628 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 |
|---|---|---|
| L2627-HCPCS | High | Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables |
| L2628-HCPCS | High | Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables |
| L2630-HCPCS | Moderate | Addition to lower extremity, pelvic control, band and belt, unilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2628. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2628 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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