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See a sample rate comparisonHCPCS L5814 Fee Schedule
Last Verified: October 2026
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.
Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Endoskeletal Knee or Hip System Additions |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L5814 |
National average reimbursement for HCPCS L5814 by major payers:
$3,767.09
$2,419.59
$2,670.28
$5,273.36
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HCPCS L5814
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$7,610.41Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$3,048.83Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$2,154.97Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$2,041.94Published rateHospital Authority Of Jenkins County
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$1,957.77Published rate
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See a sample payer proposalHCPCS L5814 vs. Other Endoskeletal Knee or Hip System Additions Codes
The HCPCS L5814 code is part of the Prosthetic Procedures services used for Endoskeletal Knee or Hip 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 L5814 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 |
|---|---|---|
| L5812-HCPCS | Moderate | Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) |
| L5814-HCPCS | High | Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock |
| L5816-HCPCS | Moderate | Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5814. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5814 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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