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See a sample rate comparisonHCPCS L3975 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Shoulder-elbow-wrist-hand-finger Orthotics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L3975 |
National average reimbursement for HCPCS L3975 by major payers:
$1,551.78
$984.98
$1,070.06
$1,501.32
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HCPCS L3975
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$3,289.26Published rateCharleston Radiologists PA
Charleston Radiologists, P.A.
$1,044.01Published rateHouston Hospitals Inc, Houston Medical Center
Houston Hospitals Inc
$839.07Published rateChatuge Regional Hospital Inc
$804.46Published rateKristina Jimenez
Miguel A Arenas Md PC
$547.38Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L3975 vs. Other Shoulder-elbow-wrist-hand-finger Orthotics Codes
The HCPCS L3975 code is part of the Orthotic Procedures and services services used for Shoulder-elbow-wrist-hand-finger 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 L3975 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 |
|---|---|---|
| L3973-HCPCS | High | Shoulder elbow wrist hand orthosis (SEWHO), abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3975-HCPCS | High | Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3976-HCPCS | High | Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, 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 L3975. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L3975 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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