HCPCS L3935 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 L3935 by major payers:
$196.77
$129.60
$144.30
$188.04
| 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 L3935 | ||||||
United | L3935 | $107.97 | 1417979501 - JEFFERSON KILPATRICK | 560942061 - (NC) PINEHURST SURGICAL CLINIC, P.A. | NC | Facial Plastic Surgery Physician (207YS0123X) |
United | L3935 | $107.97 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | L3935 | $107.97 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | L3935 | $107.97 | 1417979501 - JEFFERSON KILPATRICK | 560942061 - (NC) PINEHURST SURGICAL CLINIC, P.A. | NC | Facial Plastic Surgery Physician (207YS0123X) |
United | L3935 | $122.02 | 1417979501 - JEFFERSON KILPATRICK | 455568773 | NC | Facial Plastic Surgery Physician (207YS0123X) |
United | L3935 | $432.48 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | L3935 | $432.48 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | L3935 | $71.98 | 1619087590 - MIGUEL ARENAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
United | L3935 | $99.81 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | L3935 | $105.79 | 1912099094 - COLQUITT REGIONAL MEDICAL CENTER | 580607088 - COLQUITT REGIONAL MEDICAL CENTER | GA | General Acute Care Hospital (282N00000X) |
United | L3935 | $104.60 | 1194752840 - PATRICK REIDY | 202399514 - FLORIDA GULF COAST EAR, NOSE AND THROAT, LLC | FL | Otolaryngology Physician (207Y00000X) |
United | L3935 | $244.97 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
United | L3935 | $151.03 | 1548290943 - BUFFALO REHAB GROUP PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PC | 161379851 - BUFFALO REHAB GROUP | NY | Single Specialty Group (193400000X) |
United | L3935 | $71.98 | 1548859895 - ALICIA ENCINAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | CA | Family Nurse Practitioner (363LF0000X) |
United | L3935 | $71.98 | 1053515130 - MIGUEL A. ARENAS, M.D., PC | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
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 L3935 vs. Other Additional Miscellaneous Orthotics, Upper Extremities Codes
The HCPCS L3935 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 L3935 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 |
|---|---|---|
| L3933-HCPCS | Low | Finger orthosis (FO), without joints, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3935-HCPCS | Low | Finger orthosis (FO), nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3956-HCPCS | Low | Addition of joint to upper extremity orthosis, any material; per joint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3935. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3935 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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