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See a sample rate comparisonHCPCS L6686 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, suction socket
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Upper Extremity Prosthetic Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L6686 |
National average reimbursement for HCPCS L6686 by major payers:
$719.32
$446.02
$507.96
$974.85
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HCPCS L6686
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$1,595.06Published rateAnna Jaques Hospital
$944.77Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$472.20Published rateScreven County Hospital
$451.66Published rateMiguel Arenas
Miguel A Arenas Md PC
$235.66Published rate
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See a sample payer proposalHCPCS L6686 vs. Other Upper Extremity Prosthetic Additions Codes
The HCPCS L6686 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 L6686 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 |
|---|---|---|
| L6684-HCPCS | Moderate | Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic |
| L6686-HCPCS | Moderate | Upper extremity addition, suction socket |
| L6687-HCPCS | Moderate | Upper extremity addition, frame type socket, below elbow or wrist disarticulation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6686. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6686 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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