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See a sample rate comparisonHCPCS L5652 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, suction suspension, above knee or knee disarticulation socket
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Various Prosthetic Sockets |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5652 |
National average reimbursement for HCPCS L5652 by major payers:
$448.36
$300.55
$326.72
$619.91
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HCPCS L5652
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,182.76Published rateEmory Healthcare
Emory University
$750.96Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$353.92Published rateMichael Koch
Chestatee Pathology Associates PC
$261.05Published ratePatrick Reidy
Florida Gulf Coast Ear, Nose And Throat, LLC
$224.71Published rate
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See a sample payer proposalHCPCS L5652 vs. Other Various Prosthetic Sockets Codes
The HCPCS L5652 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 L5652 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 |
|---|---|---|
| L5651-HCPCS | High | Addition to lower extremity, above knee, flexible inner socket, external frame |
| L5652-HCPCS | Moderate | Addition to lower extremity, suction suspension, above knee or knee disarticulation socket |
| L5653-HCPCS | Moderate | Addition to lower extremity, knee disarticulation, 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 L5652. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5652 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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