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See a sample rate comparisonHCPCS L8015 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.
External breast prosthesis garment, with mastectomy form, post mastectomy
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Breast Prosthetics and Accessories |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for L8015 |
National average reimbursement for HCPCS L8015 by major payers:
$61.12
$38.95
$43.16
$85.74
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HCPCS L8015
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$135.30Published rateTift Regional Health System Inc., Tift Regional Medical Center
Tift Regional Health System Inc
$49.20Published rateLower Oconee Community Hospital Inc
$32.95Published rateTaylor Regional Hospital
$31.60Published rateAlicia Encinas
Miguel A Arenas Md PC
$21.54Published rate
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See a sample payer proposalHCPCS L8015 vs. Other Breast Prosthetics and Accessories Codes
The HCPCS L8015 code is part of the Prosthetic Procedures services used for Breast Prosthetics and Accessories. 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 L8015 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 |
|---|---|---|
| L8015-HCPCS | Low | External breast prosthesis garment, with mastectomy form, post mastectomy |
| L8020-HCPCS | Moderate | Breast prosthesis, mastectomy form |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8015. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8015 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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