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See a sample rate comparisonHCPCS L6100 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.
Below elbow, molded socket, flexible elbow hinge, triceps pad
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Below Elbow, Forearm and Hand Prosthetics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6100 |
National average reimbursement for HCPCS L6100 by major payers:
$2,345.69
$1,425.00
$1,561.68
$3,548.41
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HCPCS L6100
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$4,649.50Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$1,457.63Published rateQuest Diagnostics Incorporated
$1,260.42Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$1,086.56Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$768.28Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6100 vs. Other Below Elbow, Forearm and Hand Prosthetics Codes
The HCPCS L6100 code is part of the Prosthetic Procedures services used for Below Elbow, Forearm and Hand Prosthetics. 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 L6100 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 |
|---|---|---|
| L6055-HCPCS | High | Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad |
| L6100-HCPCS | High | Below elbow, molded socket, flexible elbow hinge, triceps pad |
| L6110-HCPCS | High | Below elbow, molded socket, (Muenster or Northwestern suspension types) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6100 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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