HCPCS L5648 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Prosthetic Procedures • Various Prosthetic Sockets |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L5648 by major payers:
$706.85
$461.75
$502.87
$1,040.32
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L5648 | ||||||
United | L5648 | $394.23 | 1972731800 - MERIWETHER HEALTHCARE, L.L.C., WARM SPRINGS MEDICAL CENTER | 870764535 - (GA) MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | L5648 | $657.04 | 1487684122 - UNION COUNTY HOSPITAL AUTHORITY, UNION GENERAL HOSPITAL | 586025393 - (GA) UNION COUNTY HOSPITAL AUTHORITY | GA | General Acute Care Hospital (282N00000X) |
United | L5648 | $394.23 | 1740272095 - DODGE COUNTY HOSPITAL AUTHORITY, DODGE COUNTY HOSPITAL | 580625140 - (GA) DODGE COUNTY HOSPITAL AUTHORITY | GA | Rural Acute Care Hospital (282NR1301X) |
United | L5648 | $343.20 | 1861478851 - CLINCH COUNTY HOSPITAL AUTHORITY | 586011853 - (GA) CLINCH COUNTY HOSPITAL AUTHORITY | GA | Critical Access Hospital (282NC0060X) |
United | L5648 | $394.23 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | L5648 | $1379.81 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L5648 | $377.76 | 1730110826 - EVANS MEMORIAL HOSPITAL, INC. | 582257925 - (GA) EVANS MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L5648 | $394.95 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 710897031 | TN | General Acute Care Hospital (282N00000X) |
United | L5648 | $377.76 | 1326079260 - HOSPITAL AUTHORITY OF LIBERTY COUNTY, LIBERTY REGIONAL MEDICAL CENTER | 586025016 | GA | Critical Access Hospital (282NC0060X) |
United | L5648 | $180.91 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 382084239 - QUEST DIAGNOSTICS CLINICAL LABORATORIES, INC. | TN | General Acute Care Hospital (282N00000X) |
United | L5648 | $398.55 | 1710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL | 581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE | GA | General Acute Care Hospital (282N00000X) |
United | L5648 | $534.46 | 1962462226 - TIFT REGIONAL HEALTH SYSTEM INC., TIFT REGIONAL MEDICAL CENTER | 453072990 - (GA) TIFT REGIONAL HEALTH SYSTEM INC | GA | General Acute Care Hospital (282N00000X) |
United | L5648 | $593.84 | 1992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL | 581928247 - (GA) PHOEBE PUTNEY MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L5648 | $394.23 | 1821017831 - BACON COUNTY HEALTH SERVICES, INC, BACON COUNTY RURAL HEALTH CLINIC | 582224545 - (GA) BACON COUNTY HEALTH SERVICES INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | L5648 | $394.23 | 1508900101 - MICHAEL KOCH | 30450086 - (GA) CHESTATEE PATHOLOGY ASSOCIATES PC | GA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L5648 vs. Other Various Prosthetic Sockets Codes
The HCPCS L5648 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 L5648 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 |
|---|---|---|
| L5647-HCPCS | Moderate | Addition to lower extremity, below knee suction socket |
| L5648-HCPCS | Moderate | Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket |
| L5649-HCPCS | High | Addition to lower extremity, ischial containment/narrow M-L socket |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5648. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5648 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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