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See a sample rate comparisonHCPCS L5639 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, below knee, wood socket
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Various Prosthetic Sockets |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L5639 |
National average reimbursement for HCPCS L5639 by major payers:
$1,255.04
$807.55
$881.02
$1,596.96
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HCPCS L5639
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$3,132.95Published rateCity Of Hope National Medical Center
$896.78Published rateChi Memorial Hospital
Chi Memorial Hospital - Georgia
$671.34Published rateThe Hospital Authority Of Miller County, Miller County Hospital - Pro Fees
The Hospital Authority Of Miller County
$584.45Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$447.55Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5639 vs. Other Various Prosthetic Sockets Codes
The HCPCS L5639 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 L5639 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 |
|---|---|---|
| L5638-HCPCS | Moderate | Addition to lower extremity, below knee, leather socket |
| L5639-HCPCS | High | Addition to lower extremity, below knee, wood socket |
| L5640-HCPCS | Moderate | Addition to lower extremity, knee disarticulation, leather socket |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5639. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5639 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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