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See a sample rate comparisonHCPCS L4010 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.
Replace trilateral socket brim
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Orthotic Replacement Parts or Repair |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L4010 |
National average reimbursement for HCPCS L4010 by major payers:
$769.96
$458.73
$492.57
$1,135.68
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HCPCS L4010
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$1,396.29Published rateKeck Medical Center Of Usc, Keck Hospital Of Usc
Keck Medical Center Of Usc
$503.85Published rateQuest Diagnostics Venture LLC
$488.16Published rateRedmond Park Hospital LLC, Redmond Hospital Based Services LLC
Redmond Park Hospital LLC
$374.64Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$359.20Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L4010 vs. Other Orthotic Replacement Parts or Repair Codes
The HCPCS L4010 code is part of the Orthotic Procedures and services services used for Orthotic Replacement Parts or Repair. 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 L4010 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 |
|---|---|---|
| L4002-HCPCS | Low | Replacement strap, any orthosis, includes all components, any length, any type |
| L4010-HCPCS | Moderate | Replace trilateral socket brim |
| L4020-HCPCS | Moderate | Replace quadrilateral socket brim, molded to patient model |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L4010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L4010 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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