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See a sample rate comparisonHCPCS L6970 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.
Interscapular-thoracic, 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
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures External Power Upper Limb Prosthetics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L6970 |
National average reimbursement for HCPCS L6970 by major payers:
$15,702.46
$10,358.05
$11,541.93
$22,989.34
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HCPCS L6970
5 of 25 sample ratesHigher to lower in this preview
Anna Jaques Hospital
$23,340.58Published rateIrwin County Hospital
$12,205.65Published rateBacon County Health Services, Inc.
Bacon County Health Services Inc
$9,003.04Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$8,627.24Published rateJenkins County Hospital LLC, Optim Medical Center - Jenkins
$7,837.68Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L6970 vs. Other External Power Upper Limb Prosthetics Codes
The HCPCS L6970 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 L6970 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 |
|---|---|---|
| L6965-HCPCS | High | Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6970-HCPCS | High | Interscapular-thoracic, 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 |
| L6975-HCPCS | High | Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, 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 L6970. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L6970 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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