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See a sample rate comparisonHCPCS L6570 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, 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 L6570 |
National average reimbursement for HCPCS L6570 by major payers:
$5,155.09
$3,137.90
$3,367.61
$7,174.16
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HCPCS L6570
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$12,204.96Published rateQuest Diagnostics LLC Il
$4,266.52Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
$3,500.87Published ratePiedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$2,423.15Published rateChristopher Raio
St Francis Hospital
$1,860.58Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6570 vs. Other Molded Socket Endoskeletal Prosthetic System, Upper Limbs Codes
The HCPCS L6570 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 L6570 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 |
|---|---|---|
| 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 |
| L6580-HCPCS | High | Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, Bowden cable control, USMC or equal pylon, no cover, molded to patient model |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6570. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6570 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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