HCPCS L5626 Fee Schedule

HCPCS L5626 vs. Other Test Socket Prosthetic Additions, Lower Extremities Codes

The HCPCS L5626 code is part of the Prosthetic Procedures services used for Test Socket 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 L5626 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.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L5626 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.