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See a sample rate comparisonHCPCS L6885 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.
Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Replacement Sockets, Upper Limbs |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6885 |
National average reimbursement for HCPCS L6885 by major payers:
$4,069.70
$2,307.21
$2,570.27
$4,316.67
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HCPCS L6885
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$6,993.23Published rateAnna Jaques Hospital
$5,097.31Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$2,109.32Published rateHospital Authority Of Jenkins County
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$1,836.29Published rateChristopher Raio
St Joseph Hospital
$1,271.50Published rate
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See a sample payer proposalHCPCS L6885 vs. Other Replacement Sockets, Upper Limbs Codes
The HCPCS L6885 code is part of the Prosthetic Procedures services used for Replacement Sockets, Upper Limbs. 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 L6885 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 |
|---|---|---|
| L6884-HCPCS | High | Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power |
| L6885-HCPCS | High | Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power |
| L6890-HCPCS | Low | Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6885. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6885 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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