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See a sample rate comparisonHCPCS L5981 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-walk system or equal
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Ankle and/or Foot Prosthetics and Additions |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L5981 |
National average reimbursement for HCPCS L5981 by major payers:
$3,174.28
$2,081.39
$2,272.02
$4,805.12
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HCPCS L5981
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$6,793.46Published rateHospital Service District Of The Parish Of St. Bernard, State Of Louis, St. Bernard Parish Hospital
Hospital Service District Of The Parish Of St Bernard State Of Louis
$3,917.83Published rateMichael Koch
Pathology Lab Of Georgia LLC
$1,724.60Published rateDevon Daney
Aztec Urgent Care LLC
$1,594.54Published rateMiguel Arenas
Miguel A Arenas Md PC
$1,149.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L5981 vs. Other Ankle and/or Foot Prosthetics and Additions Codes
The HCPCS L5981 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 L5981 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 |
|---|---|---|
| L5980-HCPCS | High | All lower extremity prostheses, flex foot system |
| L5981-HCPCS | High | All lower extremity prostheses, flex-walk system or equal |
| L5982-HCPCS | Moderate | All exoskeletal lower extremity prostheses, axial rotation unit |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L5981. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L5981 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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