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See a sample rate comparisonHCPCS L5970 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.
All lower extremity prostheses, foot, external keel, solid ankle cushion heel (SACH) foot
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Ankle and/or Foot Prosthetics and Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5970 |
National average reimbursement for HCPCS L5970 by major payers:
$233.55
$144.25
$157.47
$311.30
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HCPCS L5970
5 of 25 sample ratesHigher to lower in this preview
Ujuka Iloabuchi
Gwinnett Obgyn Associates Of Georgia LLC
$269.69Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$153.25Published rateEmory Healthcare
Cardiac Arrhythmia Institute
$121.61Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$116.52Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$105.87Published rate
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See a sample payer proposalHCPCS L5970 vs. Other Ankle and/or Foot Prosthetics and Additions Codes
The HCPCS L5970 code is part of the Prosthetic Procedures services used for Ankle and/or Foot Prosthetics and 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 L5970 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 |
|---|---|---|
| L5969-HCPCS | High | Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s) |
| L5970-HCPCS | Moderate | All lower extremity prostheses, foot, external keel, solid ankle cushion heel (SACH) foot |
| L5971-HCPCS | Moderate | All lower extremity prosthesis, solid ankle cushion heel (SACH) foot, replacement only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5970. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5970 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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