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HCPCS L6694 Fee Schedule

Last Verified: December 2025

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 FactDetail
Service Type

Prosthetic Procedures

Upper Extremity Prosthetic Additions

Complexity LevelModerate

National average reimbursement for HCPCS L6694 by major payers:

bcbs

$754.86

uhc

$479.75

aetna

$530.25

cigna

$738.38

Preview provider-level rates for...
For billing codeHCPCS L6694
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L6694

United
L6694$1732.131073502985 - CHU CHEN42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L6694$1732.131073502985 - CHU CHEN42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L6694$400.111851400485 - GEORGE HEMSTREET451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALInterventional Cardiology Physician (207RI0011X)
United
L6694$400.111952557498 - JEREMY KELLEY451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINEALFamily Nurse Practitioner (363LF0000X)
United
L6694$433.471255478004 - CHRISTOPHER RAIO208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PCNYEmergency Medicine Physician (207P00000X)
United
L6694$574.021780694620 - CARSON MEDICAL GROUP PROFESSIONAL CORPORATION880133501 - CARSON MEDICAL GROUPNVObstetrics & Gynecology Physician (207V00000X)
United
L6694$1732.131073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L6694$612.291104286418 - PHOENIX VAMC860101019AZPsychiatric Residential Treatment Facility (323P00000X)
United
L6694$1732.131073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L6694$909.401063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
L6694$602.711063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
L6694$433.471255478004 - CHRISTOPHER RAIO112050523 - ST FRANCIS HOSPITALNYEmergency Medicine Physician (207P00000X)
United
L6694$513.221619910627 - BRADLEY WEISNER562107759 - UROLOGY SPECIALISTS OF THE CAROLINAS, PLLCNCUrology Physician (208800000X)
United
L6694$1069.351619061769 - ANNA JAQUES HOSPITAL42104338 - (MA) ANNA JAQUES HOSPITALMAPsychiatric Hospital Unit (273R00000X)
United
L6694$386.581790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH582002413GAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS 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.

CodeComplexityDescription
L6693-HCPCSHighUpper extremity addition, locking elbow, forearm counterbalance
L6694-HCPCSModerateAddition 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-HCPCSModerateAddition 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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