Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS L5613 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.
Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Endoskeletal Prosthetic Additions, Lower Extremities |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L5613 |
National average reimbursement for HCPCS L5613 by major payers:
$2,640.60
$1,736.73
$1,857.47
$3,492.97
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS L5613.
HCPCS L5613
5 of 25 sample ratesHigher to lower in this preview
Emory Healthcare
Emory University
$5,104.47Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
$1,960.20Published rateMeriwether Healthcare, L.L.C., Warm Springs Medical Center
Meriwether Healthcare, LLC D/B/A Warm Springs Medical Center
$1,508.35Published rateMichael Guillette
Aztec Urgent Care LLC
$1,356.77Published rateKristina Jimenez
Miguel A Arenas Md PC
$978.29Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS L5613 vs. Other Endoskeletal Prosthetic Additions, Lower Extremities Codes
The HCPCS L5613 code is part of the Prosthetic Procedures services used for Endoskeletal Prosthetic Additions, Lower Extremities. 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 L5613 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 |
|---|---|---|
| L5611-HCPCS | High | Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with friction swing phase control |
| L5613-HCPCS | High | Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control |
| L5614-HCPCS | High | Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5613. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5613 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS L5613) and we'll show you how you compare in 15 minutes or less.