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See a sample rate comparisonHCPCS L6638 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.
Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Upper Extremity Prosthetic Additions |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6638 |
National average reimbursement for HCPCS L6638 by major payers:
$2,564.42
$1,628.95
$1,793.65
$3,580.78
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HCPCS L6638
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$5,390.02Published rateDublin Vamc
$2,058.89Published rateMiguel Arenas
Miguel A Arenas Md PC
$1,345.44Published rateJenkins County Hospital LLC, Optim Medical Center - Jenkins
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$1,318.26Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$896.96Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6638 vs. Other Upper Extremity Prosthetic Additions Codes
The HCPCS L6638 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 L6638 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 |
|---|---|---|
| L6637-HCPCS | Moderate | Upper extremity addition, nudge control elbow lock |
| L6638-HCPCS | High | Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow |
| L6640-HCPCS | Moderate | Upper extremity additions, shoulder abduction joint, pair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6638. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6638 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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