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See a sample rate comparisonHCPCS L3921 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.
Hand finger orthosis (HFO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Additional Miscellaneous Orthotics, Upper Extremities |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L3921 |
National average reimbursement for HCPCS L3921 by major payers:
$290.78
$188.38
$218.16
$280.69
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HCPCS L3921
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$628.85Published rateHospital Authority Of Valdosta And Lowndes County Georgia, South Georgia Medical Center
Hospital Authority Of Valdosta And Lowndes County Georgia
$176.64Published rateJefferson Kilpatrick
Pinehurst Surgical Clinic, P.A.
$156.97Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$153.80Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$104.63Published rate
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See a sample payer proposalHCPCS L3921 vs. Other Additional Miscellaneous Orthotics, Upper Extremities Codes
The HCPCS L3921 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 L3921 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 |
|---|---|---|
| L3919-HCPCS | Moderate | Hand orthosis (HO), without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3921-HCPCS | Moderate | Hand finger orthosis (HFO), includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3923-HCPCS | Low | Hand finger orthosis (HFO), without joints, 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 L3921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3921 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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