HCPCS L3913 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 • Additional Miscellaneous Orthotics, Upper Extremities |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L3913 by major payers:
$236.69
$158.87
$191.46
$234.24
| 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 L3913 | ||||||
United | L3913 | $149.42 | 1669404042 - THOMAS READ | 250969492 - (PA) HIGHMARK HEALTH | FL | Surgery Physician (208600000X) |
United | L3913 | $249.63 | 1144596974 - JARED WALLEN | 460319070 - MONUMENT HEALTH RAPID CITY HOSPITAL INC | FL | Urology Physician (208800000X) |
United | L3913 | $132.35 | 1790196699 - SULTAN MIRZA | 262003898 - (FL) SUNCOAST SKIN SOLUTIONS | FL | Dermatology Physician (207N00000X) |
United | L3913 | $144.32 | 1386694388 - KELLIE ANN MOSLEY-MENDEZ | 593651253 - NAPLES CENTER FOR DERMATOLOGY AND COSMETIC SURGERY | FL | Dermatology Physician (207N00000X) |
United | L3913 | $134.77 | 1245261031 - GAMAL MOSTAFA | 530204707 - HOWARD UNIVERSITY | FL | Surgery Physician (208600000X) |
United | L3913 | $128.22 | 1801896956 - JOSE PASCUAL | 593449773 - (FL) WEST PASCO PULMONARY ASSOCIATES | FL | Pulmonary Disease Physician (207RP1001X) |
United | L3913 | $148.97 | 1275977274 - SEAN MCGARVEY | 800132834 - (FL) COASTAL PULMONARY CRITICAL CARE PLC | FL | Pulmonary Disease Physician (207RP1001X) |
United | L3913 | $304.69 | 1043220254 - VASILIOS SIERROS | 611661781 | FL | Pulmonary Disease Physician (207RP1001X) |
United | L3913 | $140.22 | 1245434588 - ASFA AKHTAR | 650008133 - (FL) SKIN AND CANCER ASSOCIATES, LLP | FL | Dermatology Physician (207N00000X) |
United | L3913 | $116.63 | 1992199236 - KEVIN SEERAS | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | L3913 | $99.30 | 1841580917 - GENESISCARE USA OF FLORIDA LLC, BROWARD UROLOGY | 592485899 | FL | Urology Physician (208800000X) |
United | L3913 | $148.97 | 1700035433 - SUJATHA TADICHERLA | 472964847 - (FL) WESLEY CHAPEL DERMATOLOGY LLC | FL | Dermatology Physician (207N00000X) |
United | L3913 | $147.44 | 1073950689 - ANNA CHACON | 861385436 | FL | Dermatology Physician (207N00000X) |
United | L3913 | $142.75 | 1780350892 - JOHN COTTAM MD PA | 593759257 - (FL) JOHN COTTAM MD PA | FL | Dermatology Physician (207N00000X) |
United | L3913 | $140.22 | 1265960264 - MARY ANDERSON | 650008133 - (FL) SKIN AND CANCER ASSOCIATES, LLP | FL | Dermatology Physician (207N00000X) |
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 L3913 vs. Other Additional Miscellaneous Orthotics, Upper Extremities Codes
The HCPCS L3913 code is part of the Orthotic Procedures and services services used for Additional Miscellaneous Orthotics, Upper 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 L3913 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 |
|---|---|---|
| L3912-HCPCS | Low | Hand finger orthosis (HFO), flexion glove with elastic finger control, prefabricated, off-the-shelf |
| L3913-HCPCS | Moderate | Hand finger orthosis (HFO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3915-HCPCS | Moderate | Wrist hand orthosis (WHO), includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3913. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3913 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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