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See a sample rate comparisonHCPCS L4394 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 soft interface material, foot drop splint
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Other Lower Extremity Orthotics |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L4394 |
National average reimbursement for HCPCS L4394 by major payers:
$17.57
$11.05
$12.06
$24.57
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HCPCS L4394
5 of 25 sample ratesHigher to lower in this preview
Emory University Hospital
Emory University
$35.15Published ratePhoebe Putney Memorial Hospital Inc, Phoebe Putney Memorial Hosptial
Phoebe Physician Group Inc
$13.61Published rateQuest Diagnostics Incorporated
$9.92Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$9.43Published rateKristina Jimenez
Miguel A Arenas Md PC
$6.13Published rate
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See a sample payer proposalHCPCS L4394 vs. Other Other Lower Extremity Orthotics Codes
The HCPCS L4394 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 L4394 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 |
|---|---|---|
| L4392-HCPCS | Low | Replacement, soft interface material, static AFO |
| L4394-HCPCS | Low | Replace soft interface material, foot drop splint |
| L4396-HCPCS | Low | Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L4394. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L4394 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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