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See a sample rate comparisonHCPCS L5270 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, SACH foot
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Hip Disarticulation Prosthetics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L5270 |
National average reimbursement for HCPCS L5270 by major payers:
$6,323.47
$3,682.53
$4,053.09
$8,849.04
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HCPCS L5270
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$13,133.41Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$4,113.75Published rateKamran Rajaee
$3,093.05Published rateStephens County Hospital Authority
$2,808.46Published rateProfessional Resources Management Of Rabun, LLC, Mountain Lakes Medical Center
$2,692.67Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5270 vs. Other Hip Disarticulation Prosthetics Codes
The HCPCS L5270 code is part of the Prosthetic Procedures services used for Hip Disarticulation Prosthetics. 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 L5270 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 |
|---|---|---|
| L5250-HCPCS | High | Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot |
| L5270-HCPCS | High | Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, SACH foot |
| L5280-HCPCS | High | Hemipelvectomy, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5270. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5270 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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