HCPCS L5703 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Prosthetic Procedures • Replacement Sockets |
| Complexity Level | High |
National average reimbursement for HCPCS L5703 by major payers:
$2,490.19
$1,512.93
$1,694.38
$2,669.49
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L5703 | ||||||
United | L5703 | $2032.03 | 1487721718 - VICTORIA LEWIS-HOLLAND | 586011888 | GA | General Acute Care Hospital (282N00000X) |
United | L5703 | $1158.10 | 1205890076 - APRIL LEUZINGER | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | L5703 | $1886.83 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
United | L5703 | $1348.96 | 1740272095 - DODGE COUNTY HOSPITAL AUTHORITY, DODGE COUNTY HOSPITAL | 580625140 - (GA) DODGE COUNTY HOSPITAL AUTHORITY | GA | Rural Acute Care Hospital (282NR1301X) |
United | L5703 | $1392.83 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | L5703 | $3620.93 | 1255766531 - MARISSA LIVERIS | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Physician Assistant (363A00000X) |
United | L5703 | $1916.79 | 1104286418 - PHOENIX VAMC | 860101019 | AZ | Psychiatric Residential Treatment Facility (323P00000X) |
United | L5703 | $1796.99 | 1780694620 - CARSON MEDICAL GROUP PROFESSIONAL CORPORATION | 880133501 - CARSON MEDICAL GROUP | NV | Obstetrics & Gynecology Physician (207V00000X) |
United | L5703 | $1796.99 | 1780694620 - CARSON MEDICAL GROUP PROFESSIONAL CORPORATION | 880133501 - CARSON MEDICAL GROUP | NV | Obstetrics & Gynecology Physician (207V00000X) |
United | L5703 | $1798.61 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | L5703 | $1253.55 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | L5703 | $5190.77 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | L5703 | $2248.28 | 1528056066 - HAMILTON MEDICAL CENTER, INC. | 581519911 - HAMILTON MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L5703 | $1224.84 | 1790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH | 582002413 | GA | General Acute Care Hospital (282N00000X) |
United | L5703 | $1174.35 | 1710105119 - THE HOSPITAL AUTHORITY OF MILLER COUNTY, MILLER COUNTY HOSPITAL - PRO FEES | 586010601 - THE HOSPITAL AUTHORITY OF MILLER COUNTY | GA | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L5703 vs. Other Replacement Sockets Codes
The HCPCS L5703 code is part of the Prosthetic Procedures services used for Replacement Sockets. 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 L5703 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 |
|---|---|---|
| L5702-HCPCS | High | Replacement, socket, hip disarticulation, including hip joint, molded to patient model |
| L5703-HCPCS | High | Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only |
| L5704-HCPCS | Moderate | Custom shaped protective cover, below knee |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5703. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5703 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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