HCPCS L8515 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 • Voice Prosthetics and Accessories |
| Complexity Level | Low |
National average reimbursement for HCPCS L8515 by major payers:
$64.12
$41.14
$45.85
$62.41
| 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 L8515 | ||||||
United | L8515 | $77.05 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
United | L8515 | $32.43 | 1316561236 - CINDY CHANG | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Family Nurse Practitioner (363LF0000X) |
United | L8515 | $31.39 | 1205890076 - APRIL LEUZINGER | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | L8515 | $22.63 | 1952776023 - KRISTINA JIMENEZ | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Family Nurse Practitioner (363LF0000X) |
United | L8515 | $48.72 | 1780694620 - CARSON MEDICAL GROUP PROFESSIONAL CORPORATION | 880133501 - CARSON MEDICAL GROUP | NV | Obstetrics & Gynecology Physician (207V00000X) |
United | L8515 | $36.61 | 1225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | L8515 | $84.75 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $36.61 | 1235306648 - ST. FRANCIS RADIOLOGISTS, LLC | 475419443 | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $129.84 | 1073502985 - CHU CHEN | 42484572 | MA | Pediatrics Physician (208000000X) |
United | L8515 | $33.27 | 1083711691 - TY COBB HEALTHCARE SYSTEM, COBB MEMORIAL HOSPITAL | 580633978 - (GA) COMMUNITY SERVICES GROUP INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | L8515 | $51.81 | 1518912666 - STEPHENS COUNTY ANESTHESIA SERVICES,LLC | 300429607 - (GA) STEPHENS COUNTY ANESTHESIA SERVICESLLC | GA | Rural Acute Care Hospital (282NR1301X) |
United | L8515 | $61.29 | 1235129214 - EMANUEL COUNTY HOSPITAL AUTHORITY, EMANUEL MEDICAL CENTER | 586002922 | GA | Rural Acute Care Hospital (282NR1301X) |
United | L8515 | $51.15 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
United | L8515 | $33.95 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | L8515 | $77.05 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
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 L8515 vs. Other Voice Prosthetics and Accessories Codes
The HCPCS L8515 code is part of the Prosthetic Procedures services used for Voice 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 L8515 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 |
|---|---|---|
| L8514-HCPCS | Low | Tracheoesophageal puncture dilator, replacement only, each |
| L8515-HCPCS | Low | Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each |
| L8600-HCPCS | Moderate | Implantable breast prosthesis, silicone 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 L8515. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8515 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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