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See a sample rate comparisonHCPCS L8630 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.
Metacarpophalangeal joint implant
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Implantable Hand and Feet Prosthetics |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L8630 |
National average reimbursement for HCPCS L8630 by major payers:
$378.79
$239.85
$260.48
$397.08
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HCPCS L8630
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$682.70Published rateBacon County Health Services, Inc.
Bacon County Health Services Inc
$201.72Published rateFletcher Reynolds
Orthopedic Specialists Of Sw Florida
$191.97Published rateCaroline Saleeby
Orthopedic Specialists Of Sw Florida
$191.97Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$175.61Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS L8630 vs. Other Implantable Hand and Feet Prosthetics Codes
The HCPCS L8630 code is part of the Prosthetic Procedures services used for Implantable Hand and Feet Prosthetics. 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 L8630 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 |
|---|---|---|
| L8629-HCPCS | Low | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement |
| L8630-HCPCS | Moderate | Metacarpophalangeal joint implant |
| L8631-HCPCS | High | Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8630 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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