Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS L4090 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 metal bands KAFO-AFO, calf or distal thigh
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Orthotic Replacement Parts or Repair |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L4090 |
National average reimbursement for HCPCS L4090 by major payers:
$100.93
$60.71
$66.62
$121.11
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS L4090.
HCPCS L4090
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$179.96Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$90.61Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$61.97Published rateElbert Memorial Hospital
$48.27Published rateChristopher Raio
St Francis Hospital
$36.24Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS L4090 vs. Other Orthotic Replacement Parts or Repair Codes
The HCPCS L4090 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 L4090 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 |
|---|---|---|
| L4080-HCPCS | Low | Replace metal bands KAFO, proximal thigh |
| L4090-HCPCS | Low | Replace metal bands KAFO-AFO, calf or distal thigh |
| L4100-HCPCS | Low | Replace leather cuff KAFO, proximal thigh |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L4090. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L4090 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS L4090) and we'll show you how you compare in 15 minutes or less.