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See a sample rate comparisonHCPCS L7190 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.
Electronic elbow, adolescent, Variety Village or equal, myoelectronically controlled
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Electronic Elbow and Additions |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L7190 |
National average reimbursement for HCPCS L7190 by major payers:
$8,279.26
$5,482.48
$6,017.23
$11,963.39
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HCPCS L7190
5 of 25 sample ratesHigher to lower in this preview
Anna Jaques Hospital
$12,089.57Published rateProgressive Emergency Physicians PLLC
$5,971.29Published rateLower Oconee Community Hospital Inc
$4,196.89Published rateTaylor Regional Hospital
$4,023.87Published rateAlicia Encinas
Miguel A Arenas Md PC
$3,015.67Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L7190 vs. Other Electronic Elbow and Additions Codes
The HCPCS L7190 code is part of the Prosthetic Procedures services used for Electronic Elbow and Additions. 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 L7190 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 |
|---|---|---|
| L7186-HCPCS | High | Electronic elbow, child, Variety Village or equal, switch controlled |
| L7190-HCPCS | High | Electronic elbow, adolescent, Variety Village or equal, myoelectronically controlled |
| L7191-HCPCS | High | Electronic elbow, child, Variety Village or equal, myoelectronically controlled |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L7190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L7190 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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