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See a sample rate comparisonHCPCS L5646 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, air, fluid, gel or equal, cushion socket
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Various Prosthetic Sockets |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5646 |
National average reimbursement for HCPCS L5646 by major payers:
$600.55
$387.91
$431.50
$871.14
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HCPCS L5646
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$1,531.05Published ratePiedmont Newton Ekg Billing LLC
Piedmont Newton Hospital Inc
$727.58Published rateChristopher Raio
St Joseph Hospital
$347.41Published rateGrady Memorial Hospital Corporation, Grady Health Systems
Grady Memorial Hospital Corporation
$328.07Published rateQuest Diagnostics Venture LLC
$244.41Published rate
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See a sample payer proposalHCPCS L5646 vs. Other Various Prosthetic Sockets Codes
The HCPCS L5646 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 L5646 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 |
|---|---|---|
| L5645-HCPCS | Moderate | Addition to lower extremity, below knee, flexible inner socket, external frame |
| L5646-HCPCS | Moderate | Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket |
| L5647-HCPCS | Moderate | Addition to lower extremity, below knee suction socket |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5646. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5646 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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