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See a sample rate comparisonHCPCS L5678 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.
Additions to lower extremity, below knee, joint covers, pair
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Socket Insert, Suspensions, and Other Prosthetic Additions |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L5678 |
National average reimbursement for HCPCS L5678 by major payers:
$44.92
$27.87
$31.20
$56.47
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HCPCS L5678
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$68.40Published rateTift Regional Health System, Inc., Southwell Medical
Tift Regional Health System Inc
$32.22Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$23.77Published rateCindy Chang
Miguel A Arenas Md PC
$22.71Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$15.85Published rate
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See a sample payer proposalHCPCS L5678 vs. Other Socket Insert, Suspensions, and Other Prosthetic Additions Codes
The HCPCS L5678 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 L5678 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 |
|---|---|---|
| L5677-HCPCS | Moderate | Additions to lower extremity, below knee, knee joints, polycentric, pair |
| L5678-HCPCS | Low | Additions to lower extremity, below knee, joint covers, pair |
| L5679-HCPCS | Moderate | Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5678. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5678 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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