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See a sample rate comparisonHCPCS L5629 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.
Addition to lower extremity, below knee, acrylic socket
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Various Prosthetic Sockets |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5629 |
National average reimbursement for HCPCS L5629 by major payers:
$325.30
$234.86
$254.57
$452.13
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HCPCS L5629
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$930.31Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$257.98Published rateMichael Koch
Pathology Lab Of Georgia LLC
$190.30Published rateTattnall Hospital Company, LLC, Optim Medical Center - Tattnall
$179.11Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$126.86Published rate
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See a sample payer proposalHCPCS L5629 vs. Other Various Prosthetic Sockets Codes
The HCPCS L5629 code is part of the Prosthetic Procedures services used for Various Prosthetic Sockets. 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 L5629 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 |
|---|---|---|
| L5628-HCPCS | Moderate | Addition to lower extremity, test socket, hemipelvectomy |
| L5629-HCPCS | Moderate | Addition to lower extremity, below knee, acrylic socket |
| L5630-HCPCS | Moderate | Addition to lower extremity, Symes type, expandable wall socket |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5629. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5629 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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