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See a sample rate comparisonHCPCS L5850 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, endoskeletal system, above knee or hip disarticulation, knee extension assist
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Endoskeletal Knee or Hip System Additions |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L5850 |
National average reimbursement for HCPCS L5850 by major payers:
$132.70
$88.58
$98.96
$181.69
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HCPCS L5850
5 of 25 sample ratesHigher to lower in this preview
Emory University Hospital
Emory University
$259.22Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$77.44Published rateEmory Healthcare
$76.59Published rateElbert Memorial Hospital
$69.55Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$48.16Published rate
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See a sample payer proposalHCPCS L5850 vs. Other Endoskeletal Knee or Hip System Additions Codes
The HCPCS L5850 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 L5850 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 |
|---|---|---|
| L5848-HCPCS | High | Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability |
| L5850-HCPCS | Low | Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist |
| L5855-HCPCS | Moderate | Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5850. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5850 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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