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 L6955 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.
Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, 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 L6955 |
National average reimbursement for HCPCS L6955 by major payers:
$12,468.36
$8,184.49
$8,840.68
$17,277.64
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS L6955.
HCPCS L6955
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$26,663.30Published ratePhoebe Worth Medical Center, Inc, Phoebe Worth Medical Center, Inc
Phoebe Worth Medical Center Inc
$10,772.92Published rateQuest Diagnostics Venture LLC
$7,164.85Published rateNortheast Georgia Medical Center, Inc.
Gainesville Radiology Group
$7,151.62Published rateKeck Medical Center Of Usc, Keck Hospital Of Usc
Keck Medical Center Of Usc
$6,000.00Published 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 L6955 vs. Other External Power Upper Limb Prosthetics Codes
The HCPCS L6955 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 L6955 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 |
|---|---|---|
| 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 |
| L6955-HCPCS | High | Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6960-HCPCS | High | Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical 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 L6955. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6955 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 L6955) and we'll show you how you compare in 15 minutes or less.