HCPCS L8686 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Prosthetic Procedures • Implantable Neurostimulators and Components |
| Complexity Level | High |
National average reimbursement for HCPCS L8686 by major payers:
$5,281.41
$3,944.38
$3,464.66
$4,156.53
| 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 L8686 | ||||||
United | L8686 | $2725.56 | 1669444113 - FERDINAND MANLIO | 870792713 - (FL) F CHRISTOPHER MANLIO DO PA | FL | Dermatology Physician (207N00000X) |
United | L8686 | $4947.14 | 1275730244 - SHAHANA MASOOD | 592696419 - (FL) PULMONARY PRACTICE ASSOCIATES MD PA | FL | Pulmonary Disease Physician (207RP1001X) |
United | L8686 | $2595.85 | 1396129128 - STEPHEN LOCKWOOD | 262291600 - (FL) PALM HARBOR DERMATOLOGY PA | FL | Dermatology Physician (207N00000X) |
United | L8686 | $2741.90 | 1497799761 - MARCOS SZOMSTEIN | 203400983 - (FL) GASTRO HEALTH, LLC | FL | Colon & Rectal Surgery Physician (208C00000X) |
United | L8686 | $2796.42 | 1518993732 - ELIO DONNA | 592579938 - UNIVERSITY OF MIAMI | FL | Pulmonary Disease Physician (207RP1001X) |
United | L8686 | $7114.35 | 1053773556 - ZAHRA KHAN | 205733575 | FL | Surgery Physician (208600000X) |
United | L8686 | $2271.30 | 1073950689 - ANNA CHACON | 863112240 - (MO) REZILIENT OLH PA | FL | Dermatology Physician (207N00000X) |
United | L8686 | $2741.90 | 1356391791 - DAVID ROCK | 921919591 - (FL) PRECISION HEALTHCARE SPECIALISTS LLC | FL | Surgery Physician (208600000X) |
United | L8686 | $2725.56 | 1982711925 - THOMAS MCMEEKIN | 592897287 - (FL) ACADEMIC ALLIANCE IN DERMATOLOGY, INC. | FL | Dermatology Physician (207N00000X) |
United | L8686 | $12470.33 | 1437107778 - CELIA NELSON | 591680273 - FLORIDA CLINICAL PRACTICE ASSOCIATION INC | FL | Surgery Physician (208600000X) |
United | L8686 | $2578.37 | 1114905148 - THE EAR NOSE AND THROAT SURGICAL ASSOCIATES PA | 593213724 - (FL) THE EAR NOSE AND THROAT SURGICAL ASSOCIATES PA | FL | Otolaryngology Physician (207Y00000X) |
United | L8686 | $2553.85 | 1164422325 - FREDRIC JARRETT | 251303980 | FL | Surgery Physician (208600000X) |
United | L8686 | $4398.56 | 1457329435 - PAULDING MEDICAL CENTER, INC., WELLSTAR PAULDING HOSPITAL | 582095884 - (GA) PAULDING MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | L8686 | $24748.88 | 1790050979 - WILLIAM MILLER | 954377219 | FL | Pulmonary Disease Physician (207RP1001X) |
United | L8686 | $2741.90 | 1265615330 - RORY MCDONOUGH | 921919591 - (FL) PRECISION HEALTHCARE SPECIALISTS LLC | FL | Medical Physician Assistant (363AM0700X) |
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 L8686 vs. Other Implantable Neurostimulators and Components Codes
The HCPCS L8686 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 L8686 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 |
|---|---|---|
| L8685-HCPCS | High | Implantable neurostimulator pulse generator, single array, rechargeable, includes extension |
| L8686-HCPCS | High | Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension |
| L8687-HCPCS | High | Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8686. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8686 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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