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See a sample rate comparisonHCPCS L6640 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 additions, shoulder abduction joint, pair
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Upper Extremity Prosthetic Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L6640 |
National average reimbursement for HCPCS L6640 by major payers:
$344.44
$208.70
$234.46
$476.36
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HCPCS L6640
5 of 25 sample ratesHigher to lower in this preview
Emory University Hospital
Emory University
$676.29Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$202.03Published rateHouston Hospitals Inc, Houston Medical Center
Houston Hospitals Inc
$181.44Published ratePaulding Medical Center, Inc., Wellstar Paulding Hospital
Paulding Medical Center Inc
$173.97Published rateAlicia Encinas
Miguel A Arenas Md PC
$111.81Published rate
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See a sample payer proposalHCPCS L6640 vs. Other Upper Extremity Prosthetic Additions Codes
The HCPCS L6640 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 L6640 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 |
|---|---|---|
| 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 |
| L6641-HCPCS | Low | Upper extremity addition, excursion amplifier, pulley type |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6640 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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