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HCPCS L5653 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, knee disarticulation, expandable wall socket
Key FactDetail
Service Type

Prosthetic Procedures

Various Prosthetic Sockets

Complexity LevelModerate
Medicaid Fee ScheduleView Medicaid rates for L5653

National average reimbursement for HCPCS L5653 by major payers:

bcbs

$673.77

uhc

$408.29

aetna

$444.32

cigna

$964.55

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS L5653.

HCPCS L5653
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $1,338.08Published rate
  2. The Hospital Authority Of Monroe County, Georgia, Monroe County Hospital

    The Hospital Authority Of Monroe County Georgia

    GACritical Access HospitalNPI 1770684284Tax ID 58-6010602

    $472.45Published rate
  3. Hca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center

    TNGeneral Acute Care HospitalNPI 1023055126Tax ID 71-0897031

    $390.82Published rate
  4. Miguel Arenas

    Miguel A Arenas Md PC

    AZGastroenterology PhysicianNPI 1619087590Tax ID 30-0394179

    $348.48Published rate
  5. Miguel Arenas

    Miguel A Arenas Md PC

    AZGastroenterology PhysicianNPI 1619087590Tax ID 30-0394179

    $232.33Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS L5653 vs. Other Various Prosthetic Sockets Codes

The HCPCS L5653 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 L5653 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.

CodeComplexityDescription
L5652-HCPCSModerateAddition to lower extremity, suction suspension, above knee or knee disarticulation socket
L5653-HCPCSModerateAddition to lower extremity, knee disarticulation, expandable wall socket
L5654-HCPCSModerateAddition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5653. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L5653 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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