HCPCS L3923 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 | Low |
National average reimbursement for HCPCS L3923 by major payers:
$81.04
$51.78
$65.52
$123.46
| 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 L3923 | ||||||
United | L3923 | $233.88 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | L3923 | $47.84 | 1821017831 - BACON COUNTY HEALTH SERVICES, INC, BACON COUNTY RURAL HEALTH CLINIC | 582224545 - (GA) BACON COUNTY HEALTH SERVICES INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | L3923 | $64.86 | 1689736282 - THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY | 586002961 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L3923 | $137.63 | 1598964082 - EMORY HEALTHCARE | 582030692 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | L3923 | $223.25 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L3923 | $108.68 | 1992720791 - OMEGA HOSPITAL LLC | 470901008 - (LA) OMEGA HOSPITAL, LLC | LA | General Acute Care Hospital (282N00000X) |
United | L3923 | $47.84 | 1801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM | 581790149 - (GA) TANNER MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L3923 | $45.52 | 1386202117 - MELISSA PRATT | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Nurse Practitioner (363L00000X) |
United | L3923 | $45.52 | 1720441652 - ANDREW KUPPER | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Physical Therapist (225100000X) |
United | L3923 | $45.52 | 1326041542 - ALLEN TAFEL | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Pain Medicine (Physical Medicine & Rehabilitation) Physician (2081P2900X) |
United | L3923 | $45.52 | 1144704800 - DAVID MERKLE | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Vascular Surgery Physician (2086S0129X) |
United | L3923 | $45.52 | 1326041542 - ALLEN TAFEL | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Pain Medicine (Physical Medicine & Rehabilitation) Physician (2081P2900X) |
United | L3923 | $45.52 | 1841293065 - P RICHARDS | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | L3923 | $45.52 | 1720365547 - ALISON RIDGWAY | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Physician Assistant (363A00000X) |
United | L3923 | $45.52 | 1720187495 - ORTHOPEDIC SPECIALISTS OF SW FLORIDA, P.A. | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Orthopaedic Surgery Physician (207X00000X) |
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 L3923 vs. Other Additional Miscellaneous Orthotics, Upper Extremities Codes
The HCPCS L3923 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 L3923 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 |
|---|---|---|
| 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 |
| L3924-HCPCS | Low | Hand finger orthosis (HFO), without joints, may include soft interface, straps, prefabricated, off-the-shelf |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3923. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3923 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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