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 L7259 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 wrist rotator, any type
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Electronic Elbow and Additions |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L7259 |
National average reimbursement for HCPCS L7259 by major payers:
$4,005.88
$2,458.09
$2,659.66
$5,909.08
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS L7259.
HCPCS L7259
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$9,259.10Published rateChu Chen
$4,943.02Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$1,913.68Published rateWillamette Community Health Solutions, Cascade Health Solutions
$1,913.68Published rateChristopher Raio
St Joseph Hospital
$1,148.21Published 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 L7259 vs. Other Electronic Elbow and Additions Codes
The HCPCS L7259 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 L7259 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 |
|---|---|---|
| L7191-HCPCS | High | Electronic elbow, child, Variety Village or equal, myoelectronically controlled |
| L7259-HCPCS | High | Electronic wrist rotator, any type |
| L7360-HCPCS | Moderate | Six volt battery, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L7259. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L7259 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 L7259) and we'll show you how you compare in 15 minutes or less.