HCPCS L8680 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 Neurostimulators and Components |
| Complexity Level | Moderate |
National average reimbursement for HCPCS L8680 by major payers:
$294.69
$220.93
$196.32
$400.95
| 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 L8680 | ||||||
United | L8680 | $250.10 | 1982852448 - AMY ANSTEAD | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Otolaryngology Physician (207Y00000X) |
United | L8680 | $150.05 | 1780754499 - T DANIEL DIBBLE MD PC, SPINE TEAM SPOKANE | 431950567 - (WA) T. DANIEL DIBBLE, M.D., P.C. DBA SPINE TEAM SPOKANE | WA | Multi-Specialty Group (193200000X) |
United | L8680 | $148.86 | 1215985502 - CASCADE SURGERY ASSOCIATES, PLLC, AUBURN NEUROLOGICAL INSTITUTE | 912138096 - (WA) AUBURN NEUROLOGICAL INSTITUTE, PS DBA ASHISH TRIVEDI MD, INC | WA | Multi-Specialty Group (193200000X) |
United | L8680 | $150.05 | 1851055362 - SAND PLASTIC SURGERY, PLLC, SIXTH AVENUE SURGERY CENTER | 871494902 - (WA) SAND PLASTIC SURGERY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | L8680 | $150.05 | 1922136852 - PLANNED PARENTHOOD OF GREATER WASHINGTON & NORTH IDAHO | 916071384 - (WA) PLANNED PARENTHOOD OF GREATER WASHINGTON AND NORTH IDAHO | WA | Multi-Specialty Group (193200000X) |
United | L8680 | $125.05 | 1356055016 - BELUGA HEALTH PC | 921535934 - BELUGA HEALTH PC | WA | Multi-Specialty Clinic/Center (261QM1300X) |
United | L8680 | $150.05 | 1659582385 - SOUTHWEST PEDIATRICS | 910994224 - (WA) SOUTHWEST PEDIATRICS | WA | Multi-Specialty Group (193200000X) |
United | L8680 | $234.83 | 1376593475 - ALAN POKORNY | 911491167 | WA | Otolaryngology Physician (207Y00000X) |
United | L8680 | $234.83 | 1780769596 - PAUL LANGE | 911220843 - ASSOCIATION OF UNIVERSITY PHYSICIANS | WA | Urology Physician (208800000X) |
United | L8680 | $150.05 | 1427188465 - NORTHWEST NEUROLOGICAL PLLC | 911982165 - (WA) NORTHWEST NEUROLOGICAL, PLLC | WA | Multi-Specialty Group (193200000X) |
United | L8680 | $148.86 | 1013934918 - EVERGREEN SPEECH AND HEARING CLINIC, INC | 911307034 - (WA) EVERGREEN HEARING CLINIC, INC. | WA | Multi-Specialty Group (193200000X) |
United | L8680 | $148.86 | 1013138924 - TULALIP TRIBES OF WASHINGTON, TULALIP TRIBES FAMILY SERVICES - ADULT MENTAL WELLNESS | 910557816 - (WA) TULALIP TRIBES OF WASHINGTON | WA | Multi-Specialty Group (193200000X) |
United | L8680 | $234.83 | 1699978247 - NAE-HWA KIM | 912073120 | WA | Urology Physician (208800000X) |
United | L8680 | $251.13 | 1003349598 - WILLIAM CLINKSCALES | 621656008 - (TN) OTOLARYNGOLOGY ASSOCIATES OF TENNESSEE, P.C. | WA | Otolaryngology Physician (207Y00000X) |
United | L8680 | $234.83 | 1164482949 - TAMMY BLOOM | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Urology Physician (208800000X) |
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 L8680 vs. Other Implantable Neurostimulators and Components Codes
The HCPCS L8680 code is part of the Prosthetic Procedures services used for Implantable Neurostimulators and Components. 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 L8680 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 |
|---|---|---|
| L8679-HCPCS | High | Implantable neurostimulator, pulse generator, any type |
| L8680-HCPCS | Moderate | Implantable neurostimulator electrode, each |
| L8681-HCPCS | High | Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8680. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8680 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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