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See a sample rate comparisonHCPCS L6550 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.
Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Molded Socket Endoskeletal Prosthetic System, Upper Limbs |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6550 |
National average reimbursement for HCPCS L6550 by major payers:
$4,581.66
$2,706.03
$2,945.01
$6,423.16
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HCPCS L6550
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$8,986.03Published ratePhoebe Putney Memorial Hospital Inc, Phoebe Putney Memorial Hosptial
Phoebe Putney Memorial Hospital Inc
$3,516.33Published rateLeigh Taylor
$2,334.32Published rateScreven County Hospital, LLC, Optim Medical Center - Screven
$2,236.87Published rateDonalsonville Hospital Inc
$2,032.17Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6550 vs. Other Molded Socket Endoskeletal Prosthetic System, Upper Limbs Codes
The HCPCS L6550 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 L6550 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 |
|---|---|---|
| L6500-HCPCS | High | Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6550-HCPCS | High | Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6570-HCPCS | High | Interscapular thoracic, 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 L6550. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6550 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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