HCPCS L8630 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 • Implantable Hand and Feet Prosthetics |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L8630 by major payers:

$378.79

$239.85

$260.48

$397.08
| 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 L8630 | ||||||
United | L8630 | $191.97 | 1265430664 - SHANNAN DAVIS | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Nurse Practitioner (363L00000X) |
United | L8630 | $201.72 | 1629185285 - BACON COUNTY HEALTH SERVICES, INC. | 582224545 - (GA) BACON COUNTY HEALTH SERVICES INC | GA | Critical Access Hospital (282NC0060X) |
United | L8630 | $308.70 | 1801844469 - AUGUSTA VAMC | 582089405 - AUGUSTA VAMC | GA | General Acute Care Hospital (282N00000X) |
United | L8630 | $191.97 | 1407564610 - SAMANTHA ROCKENHAUS | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Nurse Practitioner (363L00000X) |
United | L8630 | $191.97 | 1396208922 - JASON CULLEN | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Pain Medicine (Physical Medicine & Rehabilitation) Physician (2081P2900X) |
United | L8630 | $201.72 | 1841651056 - KAMRAN RAJAEE | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | L8630 | $191.97 | 1871988279 - DALE SEGAL | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Orthopaedic Surgery of the Spine Physician (207XS0117X) |
United | L8630 | $191.97 | 1235132465 - FLETCHER REYNOLDS | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Orthopaedic Surgery Physician (207X00000X) |
United | L8630 | $191.97 | 1609289099 - JEFFREY ENGORN | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Orthopaedic Surgery Physician (207X00000X) |
United | L8630 | $191.97 | 1255475851 - KLINTON PFEIFLE | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | NV | Surgical Physician Assistant (363AS0400X) |
United | L8630 | $191.97 | 1871703488 - JASON NEMITZ | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Orthopaedic Foot and Ankle Surgery Physician (207XX0004X) |
United | L8630 | $682.70 | 1992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS | 581537752 - EMORY UNIVERSITY | GA | General Acute Care Hospital (282N00000X) |
United | L8630 | $202.11 | 1750358297 - CITY OF HOPE NATIONAL MEDICAL CENTER | 951683875 - CITY OF HOPE NATIONAL MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | L8630 | $191.97 | 1275868374 - DEBRA DEAN | 651011457 - (FL) ORTHOPEDIC SPECIALISTS OF SW FLORIDA | FL | Surgical Physician Assistant (363AS0400X) |
United | L8630 | $336.22 | 1487684122 - UNION COUNTY HOSPITAL AUTHORITY, UNION GENERAL HOSPITAL | 586025393 - (GA) UNION COUNTY HOSPITAL AUTHORITY | GA | General Acute Care Hospital (282N00000X) |
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 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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