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See a sample rate comparisonHCPCS L5692 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, above knee, pelvic control belt, light
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Socket Insert, Suspensions, and Other Prosthetic Additions |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L5692 |
National average reimbursement for HCPCS L5692 by major payers:
$149.62
$94.21
$105.27
$189.09
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HCPCS L5692
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$345.05Published rateQuest Diagnostics LLC Il
$106.27Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$95.90Published rateEvans Memorial Hospital, Inc.
Evans Memorial Hospital Inc
$76.25Published rateKristina Jimenez
Miguel A Arenas Md PC
$53.04Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5692 vs. Other Socket Insert, Suspensions, and Other Prosthetic Additions Codes
The HCPCS L5692 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 L5692 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 |
|---|---|---|
| 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 |
| L5694-HCPCS | Moderate | Addition to lower extremity, above knee, pelvic control belt, padded and lined |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5692. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5692 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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