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See a sample rate comparisonHCPCS L5975 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, combination single axis ankle and flexible keel 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 L5975 |
National average reimbursement for HCPCS L5975 by major payers:
$476.41
$302.03
$332.25
$663.17
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HCPCS L5975
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$1,046.68Published rateAtlanta Vamc
$381.69Published rateTanner Medical Center, Inc, Tanner Health System
Tanner Medical Center Inc
$280.73Published rateHospital Authority Of Jenkins County
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$244.38Published rateAlicia Encinas
Miguel A Arenas Md PC
$166.27Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5975 vs. Other Ankle and/or Foot Prosthetics and Additions Codes
The HCPCS L5975 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 L5975 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 |
|---|---|---|
| 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 |
| L5976-HCPCS | Moderate | All lower extremity prostheses, energy storing foot (seattle carbon copy II or equal) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5975. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5975 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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