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See a sample rate comparisonHCPCS L5699 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.
All lower extremity prostheses, shoulder harness
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Socket Insert, Suspensions, and Other Prosthetic Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5699 |
National average reimbursement for HCPCS L5699 by major payers:
$230.47
$137.20
$153.16
$292.28
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HCPCS L5699
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$529.58Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
$159.46Published rateQuest Diagnostics Venture LLC
$149.13Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$128.57Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$74.43Published rate
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See a sample payer proposalHCPCS L5699 vs. Other Socket Insert, Suspensions, and Other Prosthetic Additions Codes
The HCPCS L5699 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 L5699 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 |
|---|---|---|
| L5698-HCPCS | Low | Addition to lower extremity, above knee or knee disarticulation, Silesian bandage |
| L5699-HCPCS | Moderate | All lower extremity prostheses, shoulder harness |
| L5700-HCPCS | High | Replacement, socket, below knee, molded to patient model |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5699. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5699 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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