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See a sample rate comparisonHCPCS L5685 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 prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Socket Insert, Suspensions, and Other Prosthetic Additions |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L5685 |
National average reimbursement for HCPCS L5685 by major payers:
$128.77
$83.52
$92.41
$184.03
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HCPCS L5685
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$289.16Published rateAtlanta Vamc
$105.45Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$70.41Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$67.51Published rateGood Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital
Good Samaritan Hospital Inc
$51.70Published rate
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See a sample payer proposalHCPCS L5685 vs. Other Socket Insert, Suspensions, and Other Prosthetic Additions Codes
The HCPCS L5685 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 L5685 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 |
|---|---|---|
| L5684-HCPCS | Low | Addition to lower extremity, below knee, fork strap |
| L5685-HCPCS | Low | Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
| L5686-HCPCS | Low | Addition to lower extremity, below knee, back check (extension control) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5685. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5685 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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