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See a sample rate comparisonHCPCS L5980 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
All lower extremity prostheses, flex foot system
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Ankle and/or Foot Prosthetics and Additions |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L5980 |
National average reimbursement for HCPCS L5980 by major payers:
$4,056.59
$2,661.24
$2,819.51
$5,412.49
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HCPCS L5980
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$9,556.27Published rateAugusta Vamc
$3,397.39Published rateCity Of Hope National Medical Center
$2,480.00Published rateHospital Authority Of Mitchell County, Mitchell County Hospital
Hospital Authority Of Mitchell County
$2,015.85Published rateGood Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital
Good Samaritan Hospital Inc
$1,480.07Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5980 vs. Other Ankle and/or Foot Prosthetics and Additions Codes
The HCPCS L5980 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 L5980 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 |
|---|---|---|
| L5979-HCPCS | High | All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system |
| L5980-HCPCS | High | All lower extremity prostheses, flex foot system |
| L5981-HCPCS | High | All lower extremity prostheses, flex-walk system 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 L5980. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5980 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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