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See a sample rate comparisonHCPCS L3960 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.
Shoulder elbow wrist hand orthosis (SEWHO), abduction positioning, airplane design, prefabricated, includes fitting and adjustment
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Shoulder-elbow-wrist-hand Orthotics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L3960 |
National average reimbursement for HCPCS L3960 by major payers:
$727.72
$482.91
$563.87
$999.72
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HCPCS L3960
5 of 25 sample ratesHigher to lower in this preview
Charlton Stucken
Hss-Florida Physicians, LLC
$1,160.72Published rateGrzegorz Brzezicki
Memorial Neurosurgery Group LLC
$453.35Published rateF Gary Gieseke Md PA
Neurological Surgery Associates
$453.35Published rateAndrea Aedo
Steven M. Hacker, M.D., P.A.
$439.20Published rateIndian River Podiatry, PA
Indian River Podiatry PA
$404.20Published rate
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See a sample payer proposalHCPCS L3960 vs. Other Shoulder-elbow-wrist-hand Orthotics Codes
The HCPCS L3960 code is part of the Orthotic Procedures and services services used for Shoulder-elbow-wrist-hand Orthotics. 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 L3960 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 |
|---|---|---|
| L3956-HCPCS | Low | Addition of joint to upper extremity orthosis, any material; per joint |
| L3960-HCPCS | Moderate | Shoulder elbow wrist hand orthosis (SEWHO), abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
| L3961-HCPCS | High | Shoulder elbow wrist hand orthosis (SEWHO), shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L3960. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3960 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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