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See a sample rate comparisonHCPCS L5785 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, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Other Exoskeletal Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5785 |
National average reimbursement for HCPCS L5785 by major payers:
$600.07
$373.77
$416.64
$738.81
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HCPCS L5785
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,520.93Published rateLeigh Taylor
$385.36Published ratePiedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$356.29Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$329.52Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$186.66Published rate
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See a sample payer proposalHCPCS L5785 vs. Other Other Exoskeletal Additions Codes
The HCPCS L5785 code is part of the Prosthetic Procedures services used for Other Exoskeletal 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 L5785 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 |
|---|---|---|
| L5782-HCPCS | High | Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty |
| L5785-HCPCS | Moderate | Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
| L5790-HCPCS | Moderate | Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5785. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5785 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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