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See a sample rate comparisonHCPCS L6580 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Preparatory Prosthetic, Upper Limbs |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6580 |
National average reimbursement for HCPCS L6580 by major payers:
$1,865.46
$1,122.83
$1,235.93
$2,858.43
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HCPCS L6580
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$3,730.42Published rateChu Chen
$1,901.23Published rateKeck Medical Center Of Usc
$1,072.09Published rateChristopher Raio
Mercy Medical Center
$899.14Published rateKeck Medical Center Of Usc, Keck Hospital Of Usc
Keck Medical Center Of Usc
$800.00Published rate
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See a sample payer proposalHCPCS L6580 vs. Other Preparatory Prosthetic, Upper Limbs Codes
The HCPCS L6580 code is part of the Prosthetic Procedures services used for Preparatory Prosthetic, 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 L6580 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 |
|---|---|---|
| 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 |
| L6582-HCPCS | High | Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, Bowden cable control, USMC or equal pylon, no cover, direct formed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6580. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6580 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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