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See a sample rate comparisonHCPCS L6696 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.
Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L6694 or L6695)
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Upper Extremity Prosthetic Additions |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6696 |
National average reimbursement for HCPCS L6696 by major payers:
$1,354.06
$856.93
$946.53
$1,236.12
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HCPCS L6696
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$2,291.25Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$1,066.32Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$723.22Published rateMichael Guillette
Aztec Urgent Care LLC
$654.50Published rateChristopher Raio
Mercy Medical Center
$463.93Published rate
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See a sample payer proposalHCPCS L6696 vs. Other Upper Extremity Prosthetic Additions Codes
The HCPCS L6696 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 L6696 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 |
|---|---|---|
| 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 |
| L6696-HCPCS | High | Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L6694 or L6695) |
| L6697-HCPCS | High | Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code L6694 or L6695) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6696. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6696 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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