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See a sample rate comparisonHCPCS L2861 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 lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Other Lower Extremity Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L2861 |
National average reimbursement for HCPCS L2861 by major payers:
$246.78
$179.23
$138.84
$523.79
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HCPCS L2861
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See a sample payer proposalHCPCS L2861 vs. Other Other Lower Extremity Additions Codes
The HCPCS L2861 code is part of the Orthotic Procedures and services services used for Other Lower Extremity Additions. 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 L2861 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 |
|---|---|---|
| L2850-HCPCS | Low | Addition to lower extremity orthosis, femoral length sock, fracture or equal, each |
| L2861-HCPCS | Moderate | Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each |
| L2999-HCPCS | High | Lower extremity orthoses, not otherwise specified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2861. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2861 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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