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See a sample rate comparisonHCPCS L5595 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.
Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Supply, Preparatory Prosthesis |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L5595 |
National average reimbursement for HCPCS L5595 by major payers:
$4,630.68
$2,911.07
$3,184.15
$6,521.16
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HCPCS L5595
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$9,480.94Published rateQuest Diagnostics LLC Il
$4,320.00Published rateQuest Diagnostics LLC Il
$3,220.62Published rateBrooks County Hospital
$2,309.01Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$1,607.33Published rate
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See a sample payer proposalHCPCS L5595 vs. Other Supply, Preparatory Prosthesis Codes
The HCPCS L5595 code is part of the Prosthetic Procedures services used for Supply, Preparatory Prosthesis. 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 L5595 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 |
|---|---|---|
| L5590-HCPCS | High | Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, SACH foot, laminated socket, molded to model |
| L5595-HCPCS | High | Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model |
| L5600-HCPCS | High | Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, SACH foot, laminated socket, molded to patient model |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5595. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5595 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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