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See a sample rate comparisonHCPCS L5974 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, single axis ankle/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 L5974 |
National average reimbursement for HCPCS L5974 by major payers:
$271.07
$168.19
$183.03
$331.23
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HCPCS L5974
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$667.02Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$226.99Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$186.38Published rateHospital Authority Of Washington County, Washington County Regional Medical Center
$131.35Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$93.01Published rate
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See a sample payer proposalHCPCS L5974 vs. Other Ankle and/or Foot Prosthetics and Additions Codes
The HCPCS L5974 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 L5974 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 |
|---|---|---|
| L5973-HCPCS | High | Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source |
| L5974-HCPCS | Moderate | All lower extremity prostheses, foot, single axis ankle/foot |
| L5975-HCPCS | Moderate | All lower extremity prosthesis, combination single axis ankle and flexible keel foot |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5974. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5974 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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