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See a sample rate comparisonHCPCS L6635 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Upper extremity addition, lift assist for elbow
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Upper Extremity Prosthetic Additions |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L6635 |
National average reimbursement for HCPCS L6635 by major payers:
$199.97
$128.46
$140.85
$293.89
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HCPCS L6635
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$395.65Published rateTift Regional Health System Inc., Tift Regional Medical Center
Tift Regional Health System Inc
$142.97Published rateQuest Diagnostics LLC Il
$139.11Published rateFloyd Healthcare Management Inc, Atrium Health Floyd Medical Center
Floyd Healthcare Management, Inc.
$105.47Published rateRedmond Park Hospital LLC, Redmond Hospital Based Services LLC
Redmond Park Hospital LLC
$95.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6635 vs. Other Upper Extremity Prosthetic Additions Codes
The HCPCS L6635 code is part of the Prosthetic Procedures services used for Upper Extremity Prosthetic Additions. 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 L6635 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 |
|---|---|---|
| L6632-HCPCS | Low | Upper extremity addition, latex suspension sleeve, each |
| L6635-HCPCS | Low | Upper extremity addition, lift assist for elbow |
| L6637-HCPCS | Moderate | Upper extremity addition, nudge control elbow lock |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6635 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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