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 | $45.52 | 1396208922 - JASON CULLEN | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Pain Medicine (Physical Medicine & Rehabilitation) Physician (2081P2900X) |
United | L3923 | $45.52 | 1265430664 - SHANNAN DAVIS | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Nurse Practitioner (363L00000X) |
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 | 1043965650 - SARAH JOHNSON | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Surgical Physician Assistant (363AS0400X) |
United | L3923 | $45.52 | 1609295203 - BRANDON BARNES | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | TX | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | L3923 | $106.11 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L3923 | $45.52 | 1720365547 - ALISON RIDGWAY | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Physician Assistant (363A00000X) |
United | L3923 | $127.86 | 1083661409 - LALLIE KEMP MEDICAL CTR, LALLIE KEMP REGIONAL MEDICAL CENTER | 726000749 | LA | Critical Access Hospital (282NC0060X) |
United | L3923 | $47.84 | 1356860621 - CHI MEMORIAL HOSPITAL | 822748395 - CHI MEMORIAL HOSPITAL - GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | L3923 | $45.52 | 1558542092 - MAKENZI CROUSE | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Surgical Physician Assistant (363AS0400X) |
United | L3923 | $45.52 | 1255475851 - KLINTON PFEIFLE | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | NV | Surgical Physician Assistant (363AS0400X) |
United | L3923 | $45.52 | 1811476856 - TARA ZARILLO | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Physical Therapist (225100000X) |
United | L3923 | $45.52 | 1942327366 - CAROLINE SALEEBY | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Surgical Physician Assistant (363AS0400X) |
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 | 1811476856 - TARA ZARILLO | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA PA | FL | Physical Therapist (225100000X) |
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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