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See a sample rate comparisonHCPCS L5978 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, multiaxial 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 L5978 |
National average reimbursement for HCPCS L5978 by major payers:
$337.03
$208.70
$229.53
$444.94
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HCPCS L5978
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$815.47Published rateUjuka Iloabuchi
Gwinnett Obgyn Associates Of Georgia LLC
$387.54Published rateQuest Diagnostics LLC Il
$233.41Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$203.78Published rateClinch County Hospital Authority
$152.13Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5978 vs. Other Ankle and/or Foot Prosthetics and Additions Codes
The HCPCS L5978 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 L5978 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 |
|---|---|---|
| L5976-HCPCS | Moderate | All lower extremity prostheses, energy storing foot (seattle carbon copy II or equal) |
| L5978-HCPCS | Moderate | All lower extremity prostheses, foot, multiaxial ankle/foot |
| L5979-HCPCS | High | All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5978. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5978 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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