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See a sample rate comparisonHCPCS L6920 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.
Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal, switch, cables, two batteries and one charger, switch control of terminal device
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures External Power Upper Limb Prosthetics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6920 |
National average reimbursement for HCPCS L6920 by major payers:
$7,826.81
$4,807.87
$5,221.14
$11,902.51
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HCPCS L6920
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$16,745.44Published rateAnna Jaques Hospital
$10,680.11Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$4,514.72Published rateHca Health Services Of Tennessee, Inc., Tristar Centennial Medical Center
Quest Diagnostics Clinical Laboratories, Inc.
$3,760.00Published rateWildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital
Wildwood Sanitarium Incorporated
$2,664.10Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6920 vs. Other External Power Upper Limb Prosthetics Codes
The HCPCS L6920 code is part of the Prosthetic Procedures services used for External Power Upper Limb Prosthetics. 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 L6920 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 |
|---|---|---|
| L6915-HCPCS | Moderate | Hand restoration (shading, and measurements included), replacement glove for above |
| L6920-HCPCS | High | Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal, switch, cables, two batteries and one charger, switch control of terminal device |
| L6925-HCPCS | High | Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L6920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6920 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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