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See a sample rate comparisonHCPCS L6120 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 double wall split socket, step-up hinges, half cuff
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Below Elbow, Forearm and Hand Prosthetics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6120 |
National average reimbursement for HCPCS L6120 by major payers:
$2,919.80
$1,751.01
$1,914.65
$4,207.27
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HCPCS L6120
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$5,599.04Published rateQuest Diagnostics Incorporated
$1,853.45Published rateQuest Diagnostics Incorporated
$1,627.19Published rateChi Memorial Hospital
Chi Memorial Hospital - Georgia
$1,424.46Published ratePaulding Medical Center, Inc., Wellstar Paulding Hospital
Paulding Medical Center Inc
$1,240.07Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6120 vs. Other Below Elbow, Forearm and Hand Prosthetics Codes
The HCPCS L6120 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 L6120 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 |
|---|---|---|
| L6110-HCPCS | High | Below elbow, molded socket, (Muenster or Northwestern suspension types) |
| L6120-HCPCS | High | Below elbow, molded double wall split socket, step-up hinges, half cuff |
| L6130-HCPCS | High | Below elbow, molded double wall split socket, stump activated locking hinge, half cuff |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6120 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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