Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS L6945 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.
Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic 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 L6945 |
National average reimbursement for HCPCS L6945 by major payers:
$11,471.21
$7,177.84
$7,846.71
$16,582.48
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS L6945.
HCPCS L6945
5 of 25 sample ratesHigher to lower in this preview
Emory University Hospital
Emory University
$21,723.58Published rateUjuka Iloabuchi
Atlanta Womens Health Group, P.C.
$6,419.27Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$6,123.25Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$5,588.35Published rateQuest Diagnostics LLC Il
$5,120.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS L6945 vs. Other External Power Upper Limb Prosthetics Codes
The HCPCS L6945 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 L6945 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 |
|---|---|---|
| L6940-HCPCS | High | Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, Otto Bock or equal switch, cables, two batteries and one charger, switch control of terminal device |
| L6945-HCPCS | High | Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6950-HCPCS | High | Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, Otto Bock or equal switch, cables, two batteries and one charger, switch 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 L6945. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6945 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS L6945) and we'll show you how you compare in 15 minutes or less.