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See a sample rate comparisonHCPCS L4045 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 non-molded thigh lacer, for custom fabricated orthosis only
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Orthotic Replacement Parts or Repair |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L4045 |
National average reimbursement for HCPCS L4045 by major payers:
$327.64
$214.34
$227.32
$437.39
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HCPCS L4045
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$481.19Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$277.72Published rateJacob Holloway
$184.36Published rateRedmond Park Hospital LLC, Redmond Hospital Based Services LLC
Redmond Park Hospital LLC
$167.39Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$122.91Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L4045 vs. Other Orthotic Replacement Parts or Repair Codes
The HCPCS L4045 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 L4045 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 |
|---|---|---|
| L4040-HCPCS | Moderate | Replace molded thigh lacer, for custom fabricated orthosis only |
| L4045-HCPCS | Moderate | Replace non-molded thigh lacer, for custom fabricated orthosis only |
| L4050-HCPCS | Moderate | Replace molded calf lacer, for custom fabricated orthosis only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L4045. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L4045 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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