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HCPCS L3901 Fee Schedule

Last Verified: November 2025

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.

Wrist hand finger orthosis (WHFO), dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom-fabricated
Key FactDetail
Service Type

Orthotic Procedures and services

Wrist-hand-finger Orthotics

Complexity LevelHigh

National average reimbursement for HCPCS L3901 by major payers:

bcbs

$1,720.40

uhc

$1,066.41

aetna

$1,142.27

cigna

$2,682.96

Preview provider-level rates for...
For billing codeHCPCS L3901
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L3901

United
L3901$841.051750387676 - DONALD GERVAIS454460296 - (LA) NEURO DIAGNOSTIC MONITORING, LLCLANeurology Physician (2084N0400X)
United
L3901$841.051750387676 - DONALD GERVAIS454460296 - (LA) NEURO DIAGNOSTIC MONITORING, LLCLANeurology Physician (2084N0400X)
United
L3901$831.961750387676 - DONALD GERVAIS454460296 - (LA) NEURO DIAGNOSTIC MONITORING, LLCLANeurology Physician (2084N0400X)
United
L3901$883.841679845531 - DANA HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALFamily Nurse Practitioner (363LF0000X)
United
L3901$883.841306540380 - KARLIE RYAN451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALFamily Nurse Practitioner (363LF0000X)
United
L3901$883.841790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L3901$923.191235306648 - ST. FRANCIS RADIOLOGISTS, LLC475419443GAGeneral Acute Care Hospital (282N00000X)
United
L3901$1005.601174671044 - ALBANY GENERAL HOSPITAL, SAMARITAN EVERGREEN HOSPICE930110095 - ALBANY GENERAL HOSPITALORCommunity Based Hospice Care Agency (251G00000X)
United
L3901$2224.421255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN581685139 - (GA) THE MEDICAL CENTER INCGAGeneral Acute Care Hospital (282N00000X)
United
L3901$874.761790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH582002413GAGeneral Acute Care Hospital (282N00000X)
United
L3901$838.701790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH582002413GAGeneral Acute Care Hospital (282N00000X)
United
L3901$883.841922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE580572465 - CHILDRENS HEALTHCARE OF ATLANTA INCGAChildren's Hospital (282NC2000X)
United
L3901$883.841619087590 - MIGUEL ARENAS300394179 - (AZ) MIGUEL A ARENAS MD PCAZGastroenterology Physician (207RG0100X)
United
L3901$3260.281225281603 - EMORY CRAWFORD LONG HOSPITAL582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
L3901$883.841417157405 - EMORY HEALTHCARE901116753GAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS L3901 vs. Other Wrist-hand-finger Orthotics Codes

The HCPCS L3901 code is part of the Orthotic Procedures and services services used for Wrist-hand-finger Orthotics. 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 L3901 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
L3900-HCPCSHighWrist hand finger orthosis (WHFO), dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom-fabricated
L3901-HCPCSHighWrist hand finger orthosis (WHFO), dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom-fabricated
L3904-HCPCSHighWrist hand finger orthosis (WHFO), external powered, electric, custom-fabricated

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3901. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L3901 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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