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 | $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 | $34.70 | 1669488250 - ELBERT MEMORIAL HOSPITAL | 586002491 - (GA) ELBERT MEMORIAL HOSPITAL | GA | Critical Access Hospital (282NC0060X) |
United | L8515 | $51.97 | 1801844469 - AUGUSTA VAMC | 582089405 - AUGUSTA VAMC | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $33.27 | 1720189517 - TAYLOR REGIONAL HOSPITAL | 580655369 - (GA) TAYLOR REGIONAL HOSPITAL | GA | Rural Acute Care Hospital (282NR1301X) |
United | L8515 | $38.20 | 1831538743 - JACOB HOLLOWAY | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $33.95 | 1508900101 - MICHAEL KOCH | 208418894 - (GA) PATHOLOGY LAB OF GEORGIA LLC | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $51.81 | 1033435664 - SMITH OF GEORGIA, SMITH NORTHVIEW HOSPITALISTS | 271652335 - (GA) SMITH OF GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $88.23 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $51.18 | 1508361841 - CHRISTOPHER CHAMBERS | 10594994 - COOPERATIVE HEALTHCARE SERVICES INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | L8515 | $34.70 | 1982658944 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS | 721553462 | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $63.68 | 1528056066 - HAMILTON MEDICAL CENTER, INC. | 581519911 - HAMILTON MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L8515 | $33.27 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | L8515 | $36.61 | 1225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN | 273100946 | GA | Critical Access Hospital (282NC0060X) |
United | L8515 | $32.43 | 1316561236 - CINDY CHANG | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Family Nurse Practitioner (363LF0000X) |
United | L8515 | $33.27 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 273100894 | GA | Critical Access Hospital (282NC0060X) |
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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