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See a sample rate comparisonHCPCS L7191 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, child, 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 L7191 |
National average reimbursement for HCPCS L7191 by major payers:
$10,236.91
$6,725.01
$7,397.60
$15,909.49
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HCPCS L7191
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$22,494.19Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$14,225.90Published rateSmith Of Georgia, Smith Northview Hospitalists
Smith Of Georgia
$7,503.43Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$5,534.64Published rateQuest Diagnostics Venture LLC
$4,420.00Published rate
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See a sample payer proposalHCPCS L7191 vs. Other Electronic Elbow and Additions Codes
The HCPCS L7191 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 L7191 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 |
|---|---|---|
| L7190-HCPCS | High | Electronic elbow, adolescent, Variety Village or equal, myoelectronically controlled |
| L7191-HCPCS | High | Electronic elbow, child, Variety Village or equal, myoelectronically controlled |
| L7259-HCPCS | High | Electronic wrist rotator, any type |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L7191. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L7191 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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