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See a sample rate comparisonHCPCS L6694 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.
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Upper Extremity Prosthetic Additions |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L6694 |
National average reimbursement for HCPCS L6694 by major payers:
$754.86
$479.75
$530.25
$738.38
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HCPCS L6694
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,732.13Published rateAnna Jaques Hospital
$1,069.35Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$602.71Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$400.12Published rateChristopher Raio
St Joseph Hospital
$240.07Published rate
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See a sample payer proposalHCPCS L6694 vs. Other Upper Extremity Prosthetic Additions Codes
The HCPCS L6694 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 L6694 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 |
|---|---|---|
| L6693-HCPCS | High | Upper extremity addition, locking elbow, forearm counterbalance |
| L6694-HCPCS | Moderate | Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism |
| L6695-HCPCS | Moderate | Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6694. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6694 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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