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See a sample rate comparisonHCPCS L7401 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Additions for Upper Extremity Prosthetics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L7401 |
National average reimbursement for HCPCS L7401 by major payers:
$347.44
$223.51
$246.72
$463.28
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HCPCS L7401
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$705.94Published rateAztec Urgent Care, LLC
Aztec Urgent Care LLC
$278.07Published rateLower Oconee Community Hospital Inc
$188.64Published rateDana Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$184.60Published rateAlicia Encinas
Miguel A Arenas Md PC
$123.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L7401 vs. Other Additions for Upper Extremity Prosthetics Codes
The HCPCS L7401 code is part of the Prosthetic Procedures services used for Additions for Upper Extremity 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 L7401 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 |
|---|---|---|
| L7400-HCPCS | Moderate | Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal) |
| L7401-HCPCS | Moderate | Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) |
| L7402-HCPCS | Moderate | Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L7401. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L7401 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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