HCPCS L6400 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Prosthetic Procedures • Molded Socket Endoskeletal Prosthetic System, Upper Limbs |
| Complexity Level | High |
National average reimbursement for HCPCS L6400 by major payers:
$2,705.96
$1,664.38
$1,788.16
$3,863.77
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L6400 | ||||||
United | L6400 | $1284.64 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | L6400 | $1209.56 | 1720189517 - TAYLOR REGIONAL HOSPITAL | 580655369 - (GA) TAYLOR REGIONAL HOSPITAL | GA | Rural Acute Care Hospital (282NR1301X) |
United | L6400 | $1331.42 | 1245201094 - SCREVEN COUNTY HOSPITAL | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | L6400 | $2092.96 | 1487721718 - VICTORIA LEWIS-HOLLAND | 586011888 | GA | General Acute Care Hospital (282N00000X) |
United | L6400 | $926.28 | 1902957541 - WILDWOOD SANITARIUM INCORPORATED, WILDWOOD MEDICAL CLINIC | 586039864 - (GA) WILDWOOD SANITARIUM INCORPORATED | GA | General Acute Care Hospital (282N00000X) |
United | L6400 | $2126.18 | 1902855216 - ATLANTA VAMC | 582091280 | GA | General Acute Care Hospital (282N00000X) |
United | L6400 | $1209.56 | 1710105119 - THE HOSPITAL AUTHORITY OF MILLER COUNTY, MILLER COUNTY HOSPITAL - PRO FEES | 586010601 - THE HOSPITAL AUTHORITY OF MILLER COUNTY | GA | Critical Access Hospital (282NC0060X) |
United | L6400 | $1860.88 | 1861615304 - THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY, APPLING HEALTHCARE SYSTEM | 586002659 - (GA) APPLING HOSPITAL | GA | General Acute Care Hospital (282N00000X) |
United | L6400 | $1806.18 | 1881630614 - QUEST DIAGNOSTICS LLC IL | 364257926 | IL | Clinical Medical Laboratory (291U00000X) |
United | L6400 | $1389.43 | 1417157405 - EMORY HEALTHCARE | 711018941 - CARDIAC ARRHYTHMIA INSTITUTE | GA | General Acute Care Hospital (282N00000X) |
United | L6400 | $1284.64 | 1427189927 - DEVON DANEY | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Family Medicine Physician (207Q00000X) |
United | L6400 | $926.28 | 1346209137 - GOOD SAMARITAN HOSPITAL, INC., ST. MARY'S GOOD SAMARITAN HOSPITAL | 261720984 - (GA) GOOD SAMARITAN HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | L6400 | $2092.96 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
United | L6400 | $3713.37 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
United | L6400 | $2126.18 | 1801844469 - AUGUSTA VAMC | 582089405 - AUGUSTA VAMC | GA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L6400 vs. Other Molded Socket Endoskeletal Prosthetic System, Upper Limbs Codes
The HCPCS L6400 code is part of the Prosthetic Procedures services used for Molded Socket Endoskeletal Prosthetic System, 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 L6400 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 |
|---|---|---|
| L6388-HCPCS | Moderate | Immediate post surgical or early fitting, application of rigid dressing only |
| L6400-HCPCS | High | Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6450-HCPCS | High | Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6400. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6400 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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