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See a sample rate comparisonHCPCS L5460 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 non-weight bearing rigid dressing, above knee
| 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 L5460 |
National average reimbursement for HCPCS L5460 by major payers:
$592.67
$389.13
$431.35
$882.31
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HCPCS L5460
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$1,315.14Published rateAnna Jaques Hospital
$872.63Published rateKeck Medical Center Of Usc, Keck Hospital Of Usc
Keck Medical Center Of Usc
$327.10Published rateStephens County Hospital Authority
$296.54Published rateQuest Diagnostics Venture LLC
$166.77Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5460 vs. Other Prosthetic Fitting, Immediate Postsurgical or Early, Lower Limbs Codes
The HCPCS L5460 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 L5460 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 |
|---|---|---|
| L5450-HCPCS | Moderate | Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee |
| L5460-HCPCS | Moderate | Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee |
| L5500-HCPCS | High | Initial, below knee 'PTB' type socket, non-alignable system, pylon, no cover, SACH foot, plaster socket, direct formed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5460. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5460 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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