HCPCS L4361 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Orthotic Procedures and services • Other Lower Extremity Orthotics |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L4361 by major payers:
$271.19
$189.44
$219.97
$376.14
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L4361 | ||||||
United | L4361 | $203.11 | 1356621130 - JOHNATHAN THOMPSON | 320442710 | FL | Orthopaedic Trauma Physician (207XX0801X) |
United | L4361 | $207.52 | 1134116379 - LUIS MARIN | 651069359 - (FL) MARIN FOOT ANKLE CENTER PA | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | L4361 | $157.97 | 1710096805 - RANDI MEBERG | 593360315 - (FL) MEDICAL ASSOCIATES OF BREVARD, LLC | FL | Podiatrist (213E00000X) |
United | L4361 | $172.94 | 1942641618 - RIKHIL PATEL | 43155629 | MD | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | L4361 | $165.35 | 1396006482 - SCOTT VIZZI | 161626040 - (FL) ALEXANDER ORTHOPAEDIC ASSOCIATES | FL | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | L4361 | $165.35 | 1477590248 - RICHARD JOHNSON | 271667467 - (FL) COASTAL FOOT & ANKLE WELLNESS CENTER | FL | Podiatrist (213E00000X) |
United | L4361 | $168.61 | 1023013679 - PAMELA DOLBER | 542164865 - (FL) PAMELA S DOLBER DPM PA | FL | Podiatrist (213E00000X) |
United | L4361 | $165.35 | 1649233958 - ELLEN GERSHBEIN | 650339840 - (FL) DARYL GERSHBEIN DPM PA | FL | Podiatrist (213E00000X) |
United | L4361 | $158.41 | 1285085357 - WESLEY JACKSON | 273846421 - FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC, LLC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | L4361 | $165.35 | 1689756447 - CHRISTOPHER COMEY | 852031927 - (GA) ADVANCED NEUROSURGERY ASSOCIATES LLC | GA | Neurological Surgery Physician (207T00000X) |
United | L4361 | $163.86 | 1780680504 - JOHN STEVENSON | 593379430 - (FL) THE ORTHOPAEDIC INSTITUTE, P.A. | FL | Neurological Surgery Physician (207T00000X) |
United | L4361 | $165.35 | 1275734766 - DANIEL CHAN | 596014973 - (FL) SOUTH BROWARD HOSPITAL DISTRICT | FL | Orthopaedic Trauma Physician (207XX0801X) |
United | L4361 | $544.70 | 1154734606 - SAMIR KASHYAP | 852103299 - (CA) COMMUNITY HEALTH PARTNERS | FL | Neurological Surgery Physician (207T00000X) |
United | L4361 | $157.33 | 1598992505 - PUYA ALIKHANI | 237313346 - (FL) UNIVERSITY MEDICAL SERVICE ASSOCIATION INC | FL | Neurological Surgery Physician (207T00000X) |
United | L4361 | $316.04 | 1154010056 - FOOT AND ANKLE SPECIALISTS OF CLEARWATER, LLC | 923840963 - (FL) FOOT AND ANKLE SPECIALISTS OF CLEARWATER LLC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L4361 vs. Other Other Lower Extremity Orthotics Codes
The HCPCS L4361 code is part of the Orthotic Procedures and services services used for Other Lower Extremity 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 L4361 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 |
|---|---|---|
| L4360-HCPCS | Moderate | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L4361-HCPCS | Moderate | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
| L4370-HCPCS | Moderate | Pneumatic full leg splint, prefabricated, off-the-shelf |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L4361. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L4361 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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