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See a sample rate comparisonHCPCS L6380 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Prosthetic Fitting, Immediate Postsurgical or Early, Upper Limbs |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6380 |
National average reimbursement for HCPCS L6380 by major payers:
$1,350.20
$846.24
$925.44
$2,008.10
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HCPCS L6380
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$2,575.89Published rateArthur M. Blank Hospital, Inc., Arthur M. Blank Hospital
Childrens Healthcare Of Atlanta Inc
$975.17Published rateChristopher Raio
St Francis Hospital
$746.17Published rateEmory Healthcare
$688.77Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$487.58Published rate
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See a sample payer proposalHCPCS L6380 vs. Other Prosthetic Fitting, Immediate Postsurgical or Early, Upper Limbs Codes
The HCPCS L6380 code is part of the Prosthetic Procedures services used for Prosthetic Fitting, Immediate Postsurgical or Early, Upper Limbs. 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 L6380 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 |
|---|---|---|
| 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 |
| L6382-HCPCS | High | Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6380 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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