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See a sample rate comparisonHCPCS L6370 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.
Interscapular thoracic, passive restoration (shoulder cap only)
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Interscapular Thoracic, Arm, and Hand Prosthetics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6370 |
National average reimbursement for HCPCS L6370 by major payers:
$2,303.95
$1,521.34
$1,622.33
$3,435.77
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HCPCS L6370
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$4,705.66Published ratePhoebe Putney Memorial Hospital Inc, Phoebe Putney Memorial Hosptial
Phoebe Putney Memorial Hospital Inc
$1,901.26Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$1,651.60Published rateHouston Hospitals Inc, Houston Medical Center
Houston Hospitals Inc
$1,146.03Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$841.42Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6370 vs. Other Interscapular Thoracic, Arm, and Hand Prosthetics Codes
The HCPCS L6370 code is part of the Prosthetic Procedures services used for Interscapular Thoracic, 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 L6370 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 |
|---|---|---|
| L6360-HCPCS | High | Interscapular thoracic, passive restoration (complete prosthesis) |
| L6370-HCPCS | High | Interscapular thoracic, passive restoration (shoulder cap only) |
| L6380-HCPCS | High | Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6370. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6370 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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