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HCPCS L6320 Fee Schedule

Last Verified: December 2025

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.

Shoulder disarticulation, passive restoration (shoulder cap only)
Key FactDetail
Service Type

Prosthetic Procedures

Shoulder Disarticulation, Arm and Hand Prosthetics

Complexity LevelHigh

National average reimbursement for HCPCS L6320 by major payers:

bcbs

$1,917.70

uhc

$1,230.77

aetna

$1,358.17

cigna

$2,975.11

Preview provider-level rates for...
For billing codeHCPCS L6320
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L6320

United
L6320$1063.831710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLEGAGeneral Acute Care Hospital (282N00000X)
United
L6320$1052.261992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS262037695 - GRADY MEMORIAL HOSPITAL CORPORATIONGAGeneral Acute Care Hospital (282N00000X)
United
L6320$1456.331366479099 - UNILAB CORPORATION, QUEST DIAGNOSTICS CLINICAL LAB710897031CAClinical Medical Laboratory (291U00000X)
United
L6320$955.451790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH582002413GAGeneral Acute Care Hospital (282N00000X)
United
L6320$3026.921225281603 - EMORY CRAWFORD LONG HOSPITAL582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
L6320$1150.671922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE580572465 - CHILDRENS HEALTHCARE OF ATLANTA INCGAChildren's Hospital (282NC2000X)
United
L6320$3923.121588640692 - EMORY UNIVERSITY, EMORY UNIVERSITY HOSPITAL580566256 - (GA) EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
L6320$1366.911881630614 - QUEST DIAGNOSTICS LLC IL364257926ILClinical Medical Laboratory (291U00000X)
United
L6320$1366.911366479099 - UNILAB CORPORATION, QUEST DIAGNOSTICS CLINICAL LAB710897031CAClinical Medical Laboratory (291U00000X)
United
L6320$1366.911023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER710897031TNGeneral Acute Care Hospital (282N00000X)
United
L6320$1366.911619040284 - QUEST DIAGNOSTICS VENTURE LLC232933949PAClinical Medical Laboratory (291U00000X)
United
L6320$1585.091992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL263792403 - PHOEBE PHYSICIAN GROUP INCGAGeneral Acute Care Hospital (282N00000X)
United
L6320$916.051720189517 - TAYLOR REGIONAL HOSPITAL580655369 - (GA) TAYLOR REGIONAL HOSPITALGARural Acute Care Hospital (282NR1301X)
United
L6320$1052.261801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM581790149 - (GA) TANNER MEDICAL CENTER INCGAGeneral Acute Care Hospital (282N00000X)
United
L6320$916.051790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH582002413GAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS L6320 vs. Other Shoulder Disarticulation, Arm and Hand Prosthetics Codes

The HCPCS L6320 code is part of the Prosthetic Procedures services used for Shoulder Disarticulation, Arm 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 L6320 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.

CodeComplexityDescription
L6310-HCPCSHighShoulder disarticulation, passive restoration (complete prosthesis)
L6320-HCPCSHighShoulder disarticulation, passive restoration (shoulder cap only)
L6350-HCPCSHighInterscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6320. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L6320 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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