HCPCS L6450 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 L6450 by major payers:

$3,545.28

$2,191.83

$2,346.35

$5,050.80
| 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 L6450 | ||||||
United | L6450 | $1846.10 | 1679845531 - DANA HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | L6450 | $1846.10 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | L6450 | $8864.94 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | L6450 | $3114.45 | 1619040284 - QUEST DIAGNOSTICS VENTURE LLC | 232933949 | PA | Clinical Medical Laboratory (291U00000X) |
United | L6450 | $2262.36 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 382084239 - QUEST DIAGNOSTICS CLINICAL LABORATORIES, INC. | TN | General Acute Care Hospital (282N00000X) |
United | L6450 | $3114.45 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 710897031 | TN | General Acute Care Hospital (282N00000X) |
United | L6450 | $3114.45 | 1932145778 - QUEST DIAGNOSTICS INCORPORATED | 161387862 - QUEST DIAGNOSTICS INCORPORATED | NJ | Clinical Medical Laboratory (291U00000X) |
United | L6450 | $2262.36 | 1932145778 - QUEST DIAGNOSTICS INCORPORATED | 161387862 - QUEST DIAGNOSTICS INCORPORATED | NJ | Clinical Medical Laboratory (291U00000X) |
United | L6450 | $2262.36 | 1023055126 - HCA HEALTH SERVICES OF TENNESSEE, INC., TRISTAR CENTENNIAL MEDICAL CENTER | 710897031 | TN | General Acute Care Hospital (282N00000X) |
United | L6450 | $2262.36 | 1013514199 - KECK MEDICAL CENTER OF USC, KECK HOSPITAL OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | L6450 | $2262.36 | 1417554528 - KECK MEDICAL CENTER OF USC | 851644866 - (CA) KECK MEDICAL CENTER OF USC | CA | General Acute Care Hospital (282N00000X) |
United | L6450 | $4116.56 | 1306136551 - UJUKA ILOABUCHI | 881014763 | GA | Women's Hospital (282NW0100X) |
United | L6450 | $3114.45 | 1881630614 - QUEST DIAGNOSTICS LLC IL | 364257926 | IL | Clinical Medical Laboratory (291U00000X) |
United | L6450 | $2262.36 | 1619040284 - QUEST DIAGNOSTICS VENTURE LLC | 232933949 | PA | Clinical Medical Laboratory (291U00000X) |
United | L6450 | $2262.36 | 1881630614 - QUEST DIAGNOSTICS LLC IL | 364257926 | IL | Clinical Medical Laboratory (291U00000X) |
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 L6450 vs. Other Molded Socket Endoskeletal Prosthetic System, Upper Limbs Codes
The HCPCS L6450 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 L6450 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 |
|---|---|---|
| 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 |
| L6500-HCPCS | High | Above elbow, 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 L6450. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6450 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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