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See a sample rate comparisonHCPCS L5410 Fee Schedule
Last Verified: October 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.
Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Prosthetic Fitting, Immediate Postsurgical or Early, Lower Limbs |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5410 |
National average reimbursement for HCPCS L5410 by major payers:
$464.77
$298.98
$333.88
$629.49
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HCPCS L5410
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$846.65Published rateSmith Of Georgia, Smith Northview Hospitalists
Smith Of Georgia
$339.17Published rateBacon County Health Services, Inc, Bacon County Rural Health Clinic
Bacon County Health Services Inc
$250.17Published rateNavicent Health Oconee, LLC, Navicent Health Baldwin
Navicent Health Oconee LLC
$227.16Published rateAlicia Encinas
Miguel A Arenas Md PC
$166.78Published rate
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See a sample payer proposalHCPCS L5410 vs. Other Prosthetic Fitting, Immediate Postsurgical or Early, Lower Limbs Codes
The HCPCS L5410 code is part of the Prosthetic Procedures services used for Prosthetic Fitting, Immediate Postsurgical or Early, Lower Limbs. 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 L5410 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 |
|---|---|---|
| L5400-HCPCS | High | Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee |
| L5410-HCPCS | Moderate | Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment |
| L5420-HCPCS | High | Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'AK' or knee disarticulation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5410. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5410 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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