HCPCS L5780 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 • Exoskeletal Knee-shin System Additions |
| Complexity Level | High |
National average reimbursement for HCPCS L5780 by major payers:

$1,253.91

$821.11

$899.86

$1,886.92
| 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 L5780 | ||||||
United | L5780 | $596.82 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L5780 | $2320.01 | 1225281603 - EMORY CRAWFORD LONG HOSPITAL | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | L5780 | $915.76 | 1881630614 - QUEST DIAGNOSTICS LLC IL | 364257926 | IL | Clinical Medical Laboratory (291U00000X) |
United | L5780 | $622.47 | 1962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER | 711045290 - (GA) HOUSTON HOSPITALS INC | GA | General Acute Care Hospital (282N00000X) |
United | L5780 | $646.53 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L5780 | $685.55 | 1659376630 - UPSON COUNTY HOSPITAL INC, UPSON REGIONAL MEDICAL CENTER | 581734026 - (GA) UPSON COUNTY HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L5780 | $596.82 | 1326028978 - CHATUGE REGIONAL HOSPITAL INC | 582513901 - CHATUGE REGIONAL HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | L5780 | $929.41 | 1518912666 - STEPHENS COUNTY ANESTHESIA SERVICES,LLC | 300429607 - (GA) STEPHENS COUNTY ANESTHESIA SERVICESLLC | GA | Rural Acute Care Hospital (282NR1301X) |
United | L5780 | $1032.68 | 1487721718 - VICTORIA LEWIS-HOLLAND | 586011888 | GA | General Acute Care Hospital (282N00000X) |
United | L5780 | $996.65 | 1881630614 - QUEST DIAGNOSTICS LLC IL | 364257926 | IL | Clinical Medical Laboratory (291U00000X) |
United | L5780 | $915.76 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 710897031 | TN | General Acute Care Hospital (282N00000X) |
United | L5780 | $996.65 | 1619040284 - QUEST DIAGNOSTICS VENTURE LLC | 232933949 | PA | Clinical Medical Laboratory (291U00000X) |
United | L5780 | $996.65 | 1366479099 - UNILAB CORPORATION, QUEST DIAGNOSTICS CLINICAL LAB | 710897031 | CA | Clinical Medical Laboratory (291U00000X) |
United | L5780 | $996.65 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 710897031 | TN | General Acute Care Hospital (282N00000X) |
United | L5780 | $929.41 | 1770684284 - THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA, MONROE COUNTY HOSPITAL | 586010602 - (GA) THE HOSPITAL AUTHORITY OF MONROE COUNTY GEORGIA | 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 L5780 vs. Other Exoskeletal Knee-shin System Additions Codes
The HCPCS L5780 code is part of the Prosthetic Procedures services used for Exoskeletal Knee-shin System 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 L5780 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 |
|---|---|---|
| L5728-HCPCS | High | Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control |
| L5780-HCPCS | High | Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control |
| L5781-HCPCS | High | Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5780. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5780 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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