HCPCS L8465 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Prosthetic Procedures • Prosthetic Sheaths, Socks, and Shrinkers |
| Complexity Level | Low |
National average reimbursement for HCPCS L8465 by major payers:
$57.81
$36.63
$41.59
$85.66
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS L8465 | ||||||
United | L8465 | $112.53 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | L8465 | $112.52 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L8465 | $49.25 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | L8465 | $37.31 | 1811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM | 474393589 - (GA) EFFINGHAM HOSPITAL INC | GA | Critical Access Hospital (282NC0060X) |
United | L8465 | $38.95 | 1306136551 - UJUKA ILOABUCHI | 582483738 | GA | Women's Hospital (282NW0100X) |
United | L8465 | $58.65 | 1992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL | 263792403 - PHOEBE PHYSICIAN GROUP INC | GA | General Acute Care Hospital (282N00000X) |
United | L8465 | $33.90 | 1225031750 - JASPER HEALTH SERVICES, INC., JASPER MEMORIAL HOSPITAL | 582510435 - (GA) JASPER HEALTH SERVICES INC | GA | Critical Access Hospital (282NC0060X) |
United | L8465 | $52.15 | 1508361841 - CHRISTOPHER CHAMBERS | 10594994 - COOPERATIVE HEALTHCARE SERVICES INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | L8465 | $44.70 | 1033168257 - DUBLIN VAMC | 582080668 - (GA) DUBLIN VAMC | GA | General Acute Care Hospital (282N00000X) |
United | L8465 | $60.06 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L8465 | $26.29 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | L8465 | $49.25 | 1376574277 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL FORSYTH | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L8465 | $107.42 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L8465 | $38.95 | 1649646472 - LEIGH TAYLOR | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | L8465 | $86.37 | 1306136551 - UJUKA ILOABUCHI | 474870066 - (GA) GWINNETT OBGYN ASSOCIATES OF GEORGIA LLC | GA | Women's Hospital (282NW0100X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS L8465 vs. Other Prosthetic Sheaths, Socks, and Shrinkers Codes
The HCPCS L8465 code is part of the Prosthetic Procedures services used for Prosthetic Sheaths, Socks, and Shrinkers. 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 L8465 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 |
|---|---|---|
| L8460-HCPCS | Low | Prosthetic shrinker, above knee, each |
| L8465-HCPCS | Low | Prosthetic shrinker, upper limb, each |
| L8470-HCPCS | Low | Prosthetic sock, single ply, fitting, below knee, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8465. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8465 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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