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See a sample rate comparisonHCPCS L5971 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 prosthesis, solid ankle cushion heel (SACH) foot, replacement only
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Ankle and/or Foot Prosthetics and Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L5971 |
National average reimbursement for HCPCS L5971 by major payers:
$234.75
$144.21
$156.57
$209.17
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HCPCS L5971
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$594.53Published rateHamilton Medical Center, Inc.
Hamilton Medical Center Inc
$202.67Published rateNgmc Barrow LLC, Ngmc Barrow
Gainesville Radiology Group
$121.61Published rateDevon Daney
Aztec Urgent Care LLC
$112.44Published rateAlicia Encinas
Miguel A Arenas Md PC
$81.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5971 vs. Other Ankle and/or Foot Prosthetics and Additions Codes
The HCPCS L5971 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 L5971 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 |
|---|---|---|
| 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 |
| L5972-HCPCS | Moderate | All lower extremity prostheses, foot, flexible keel |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5971. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5971 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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