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See a sample rate comparisonHCPCS L5690 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, below knee, waist belt, padded and lined
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Socket Insert, Suspensions, and Other Prosthetic Additions |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L5690 |
National average reimbursement for HCPCS L5690 by major payers:
$115.09
$72.18
$77.99
$176.50
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HCPCS L5690
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$286.46Published rateAugusta Vamc
$89.66Published rateQuest Diagnostics LLC Il
$72.00Published rateTattnall Hospital Company, LLC, Optim Medical Center - Tattnall
$55.15Published rateGood Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital
Good Samaritan Hospital Inc
$39.06Published rate
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See a sample payer proposalHCPCS L5690 vs. Other Socket Insert, Suspensions, and Other Prosthetic Additions Codes
The HCPCS L5690 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 L5690 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 |
|---|---|---|
| L5688-HCPCS | Low | Addition to lower extremity, below knee, waist belt, webbing |
| L5690-HCPCS | Low | Addition to lower extremity, below knee, waist belt, padded and lined |
| L5692-HCPCS | Low | Addition to lower extremity, above knee, pelvic control belt, light |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5690. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5690 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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