HCPCS L5673 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 • Socket Insert, Suspensions, and Other Prosthetic Additions |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L5673 by major payers:
$724.98
$479.64
$530.41
$1,112.42
| 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 L5673 | ||||||
United | L5673 | $425.76 | 1629185285 - BACON COUNTY HEALTH SERVICES, INC. | 582224545 - (GA) BACON COUNTY HEALTH SERVICES INC | GA | Critical Access Hospital (282NC0060X) |
United | L5673 | $682.75 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L5673 | $425.76 | 1306136551 - UJUKA ILOABUCHI | 582422542 - ATLANTA WOMENS HEALTH GROUP, P.C. | GA | Women's Hospital (282NW0100X) |
United | L5673 | $709.61 | 1528056066 - HAMILTON MEDICAL CENTER, INC. | 581519911 - HAMILTON MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $577.21 | 1689736282 - THE HOSPITAL AUTHORITY OF HABERSHAM COUNTY | 586002961 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L5673 | $641.35 | 1487721718 - VICTORIA LEWIS-HOLLAND | 586011888 | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $641.35 | 1992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL | 581928247 - (GA) PHOEBE PUTNEY MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $386.58 | 1316938459 - NAVICENT HEALTH OCONEE, LLC, NAVICENT HEALTH BALDWIN | 582359398 - NAVICENT HEALTH OCONEE LLC | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $408.00 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | L5673 | $944.22 | 1689063554 - ATL COLORECTAL SURGERY | 205040872 - (GA) ATL COLORECTAL SURGERY | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $425.76 | 1831538743 - JACOB HOLLOWAY | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $283.85 | 1235153883 - WILDWOOD SANITARIUM, INCORPORATED, WILDWOOD LIFESTYLE CENTER AND HOSPITAL | 586039864 - (GA) WILDWOOD SANITARIUM INCORPORATED | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $370.66 | 1497064679 - JENKINS COUNTY HOSPITAL LLC, OPTIM MEDICAL CENTER - JENKINS | 273100894 | GA | Critical Access Hospital (282NC0060X) |
United | L5673 | $425.76 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | GA | General Acute Care Hospital (282N00000X) |
United | L5673 | $438.67 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
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 L5673 vs. Other Socket Insert, Suspensions, and Other Prosthetic Additions Codes
The HCPCS L5673 code is part of the Prosthetic Procedures services used for Socket Insert, Suspensions, and Other Prosthetic Additions. 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 L5673 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 |
|---|---|---|
| L5672-HCPCS | Moderate | Addition to lower extremity, below knee, removable medial brim suspension |
| L5673-HCPCS | Moderate | Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism |
| L5676-HCPCS | Moderate | Additions to lower extremity, below knee, knee joints, single axis, pair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5673. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5673 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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