HCPCS L2630 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Orthotic Procedures and services • Additions, Pelvic and/or Thoracic Control, Lower Extremities |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L2630 by major payers:
$252.21
$164.85
$175.45
$329.95
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L2630 | ||||||
United | L2630 | $632.72 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | L2630 | $632.71 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L2630 | $212.97 | 1902855216 - ATLANTA VAMC | 582091280 | GA | General Acute Care Hospital (282N00000X) |
United | L2630 | $113.00 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | L2630 | $188.69 | 1962462226 - TIFT REGIONAL HEALTH SYSTEM INC., TIFT REGIONAL MEDICAL CENTER | 453072990 - (GA) TIFT REGIONAL HEALTH SYSTEM INC | GA | General Acute Care Hospital (282N00000X) |
United | L2630 | $131.25 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L2630 | $470.98 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | L2630 | $185.91 | 1013514199 - KECK MEDICAL CENTER OF USC, KECK HOSPITAL OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | L2630 | $282.49 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | L2630 | $209.64 | 1487721718 - VICTORIA LEWIS-HOLLAND | 586011888 | GA | General Acute Care Hospital (282N00000X) |
United | L2630 | $603.96 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L2630 | $231.96 | 1528056066 - HAMILTON MEDICAL CENTER, INC. | 581519911 - HAMILTON MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L2630 | $185.57 | 1689744450 - ARTHUR M. BLANK HOSPITAL, INC., ARTHUR M. BLANK HOSPITAL | 582147112 - (GA) CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | L2630 | $518.88 | 1588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL | 580566256 - (GA) EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | L2630 | $185.91 | 1366479099 - UNILAB CORPORATION, QUEST DIAGNOSTICS CLINICAL LAB | 710897031 | CA | Clinical Medical Laboratory (291U00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L2630 vs. Other Additions, Pelvic and/or Thoracic Control, Lower Extremities Codes
The HCPCS L2630 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 L2630 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 |
|---|---|---|
| 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 |
| L2640-HCPCS | Moderate | Addition to lower extremity, pelvic control, band and belt, bilateral |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2630 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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