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See a sample rate comparisonHCPCS L8499 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.
Unlisted procedure for miscellaneous prosthetic services
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Unlisted Prosthetic Procedures |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L8499 |
National average reimbursement for HCPCS L8499 by major payers:
$1,282.93
$74.60
$56.86
$515.62
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HCPCS L8499
5 of 19 sample ratesHigher to lower in this preview
Quest Diagnostics LLC Il
$53.09Published rateUnilab Corporation, Quest Diagnostics Clinical Lab
$53.09Published rateAlbany General Hospital, Samaritan Evergreen Hospice
Albany General Hospital
$53.09Published rateQuest Diagnostics Incorporated
$53.09Published rateCity Of Hope National Medical Center
$53.09Published rate
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See a sample payer proposalHCPCS L8499 vs. Other Unlisted Prosthetic Procedures Codes
The HCPCS L8499 code is part of the Prosthetic Procedures services used for Unlisted Prosthetic Procedures. 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 L8499 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 |
|---|---|---|
| L8485-HCPCS | Low | Prosthetic sock, single ply, fitting, upper limb, each |
| L8499-HCPCS | High | Unlisted procedure for miscellaneous prosthetic services |
| L8500-HCPCS | Moderate | Artificial larynx, 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 L8499. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8499 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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