Data Platform
Sign InTry for Free

HCPCS L8631 Fee Schedule

Last Verified: December 2025

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.

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)
Key FactDetail
Service Type

Prosthetic Procedures

Implantable Hand and Feet Prosthetics

Complexity LevelHigh

National average reimbursement for HCPCS L8631 by major payers:

bcbs

$2,227.29

uhc

$1,436.80

aetna

$1,589.61

cigna

$2,149.63

Preview provider-level rates for...
For billing codeHCPCS L8631
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS L8631

United
L8631$1353.851508900101 - MICHAEL KOCH30450086 - (GA) CHESTATEE PATHOLOGY ASSOCIATES PCGAGeneral Acute Care Hospital (282N00000X)
United
L8631$1183.981881144889 - NGMC BARROW LLC, NGMC BARROW581177261 - (GA) GAINESVILLE RADIOLOGY GROUPGAGeneral Acute Care Hospital (282N00000X)
United
L8631$1783.511063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
L8631$1783.511063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
L8631$1094.681427189927 - DEVON DANEY271495988 - (NM) AZTEC URGENT CARE LLCCOFamily Medicine Physician (207Q00000X)
United
L8631$1094.681174512115 - MICHAEL GUILLETTE271495988 - (NM) AZTEC URGENT CARE LLCCOPhysician Assistant (363A00000X)
United
L8631$1811.821104286418 - PHOENIX VAMC860101019AZPsychiatric Residential Treatment Facility (323P00000X)
United
L8631$4809.531073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
L8631$1698.581780694620 - CARSON MEDICAL GROUP PROFESSIONAL CORPORATION880133501 - CARSON MEDICAL GROUPNVObstetrics & Gynecology Physician (207V00000X)
United
L8631$1178.601790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH582002413GAGeneral Acute Care Hospital (282N00000X)
United
L8631$2039.391639157431 - PHOEBE WORTH MEDICAL CENTER, INC, PHOEBE WORTH MEDICAL CENTER, INC383647394 - (GA) PHOEBE WORTH MEDICAL CENTER INCGACritical Access Hospital (282NC0060X)
United
L8631$2649.461063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
L8631$1178.601326028978 - CHATUGE REGIONAL HOSPITAL INC582513901 - CHATUGE REGIONAL HOSPITAL INCGACritical Access Hospital (282NC0060X)
United
L8631$1368.751710992433 - HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLE, JEFFERSON HOSPITAL581309961 - (GA) HOSPITAL AUTHORITY OF JEFFERSON COUNTY AND THE CITY OF LOUISVILLEGAGeneral Acute Care Hospital (282N00000X)
United
L8631$4581.601225281603 - EMORY CRAWFORD LONG HOSPITAL581537752 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

HCPCS L8631 vs. Other Implantable Hand and Feet Prosthetics Codes

The HCPCS L8631 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 L8631 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.

CodeComplexityDescription
L8630-HCPCSModerateMetacarpophalangeal joint implant
L8631-HCPCSHighMetacarpal 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)
L8641-HCPCSModerateMetatarsal joint implant

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8631. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the L8631 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like HCPCS L8631) and we'll show you how you compare in 15 minutes or less.