HCPCS L8690 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 • Miscellaneous Orthotic and Prosthetic Services and Supplies |
| Complexity Level | High |
National average reimbursement for HCPCS L8690 by major payers:
$4,807.41
$3,096.62
$3,519.09
$6,949.05
| 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 L8690 | ||||||
United | L8690 | $4266.81 | 1376590026 - PUBLIC HOSPITAL DISTRICT #1 OF KING COUNTY, VMC KENT PRIMARY CARE | 916000986 - (WA) PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY | WA | Multi-Specialty Group (193200000X) |
United | L8690 | $2966.53 | 1871882548 - KYLE SCHUYLER | 251679140 - HIGHMARK HEALTH | WA | Urology Physician (208800000X) |
United | L8690 | $4266.81 | 1801032842 - SEPEHR OLIAEI | 911352172 - MULTICARE HEALTH SYSTEM | WA | Otolaryngology Physician (207Y00000X) |
United | L8690 | $2367.01 | 1225572381 - ACUTE PAIN MANAGEMENT PLLC | 813123328 - (WA) ACUTE PAIN MANAGEMENT PLLC | WA | Multi-Specialty Group (193200000X) |
United | L8690 | $4884.31 | 1518943646 - JOSEPH SNIEZEK | 912073120 | WA | Otolaryngology Physician (207Y00000X) |
United | L8690 | $4266.81 | 1477594356 - PACMED CLINICS | 562290878 - (WA) PACMED CLINICS | WA | Multi-Specialty Clinic/Center (261QM1300X) |
United | L8690 | $4884.31 | 1447719760 - NIKOLAS BLOCK-WHEELER | 911220843 - ASSOCIATION OF UNIVERSITY PHYSICIANS | WA | Otolaryngology Physician (207Y00000X) |
United | L8690 | $6842.37 | 1982939955 - LINDSAY HAMPSON | 943281666 | WA | Urology Physician (208800000X) |
United | L8690 | $3856.40 | 1093891103 - LISA MULLIGAN | 383318698 - LISA MULLIGAN , MD | WA | Otolaryngology Physician (207Y00000X) |
United | L8690 | $3856.40 | 1639396930 - TRISHA KRUGER | 916001698 | WA | Urology Physician (208800000X) |
United | L8690 | $2436.16 | 1316335417 - USA VEIN CLINICS OF BELLEVUE, PLLC | 472533941 - (WA) USA VEIN CLINICS OF BELLEVUE PLLC | WA | Multi-Specialty Group (193200000X) |
United | L8690 | $19173.60 | 1235472200 - MARIANNE ABOUYARED | 680334324 | WA | Otolaryngology Physician (207Y00000X) |
United | L8690 | $4228.75 | 1750336129 - FRANCISCAN MEDICAL GROUP, FMG-THE LAKEWOOD CLINIC, FAMILY MEDICINE AND WOMEN'S HEALTHCARE | 911939739 - FRANCISCAN MEDICAL GROUP | WA | Multi-Specialty Group (193200000X) |
United | L8690 | $4266.81 | 1124313358 - NIVEDITA SAHU | 910565539 - (WA) VIRGINIA MASON MEDICAL CENTER | FL | Otolaryngology Physician (207Y00000X) |
United | L8690 | $2311.54 | 1659582385 - SOUTHWEST PEDIATRICS | 910994224 - (WA) SOUTHWEST PEDIATRICS | WA | Multi-Specialty Group (193200000X) |
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 L8690 vs. Other Miscellaneous Orthotic and Prosthetic Services and Supplies Codes
The HCPCS L8690 code is part of the Prosthetic Procedures services used for Miscellaneous Orthotic and Prosthetic Services and Supplies. 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 L8690 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 |
|---|---|---|
| L8689-HCPCS | High | External recharging system for battery (internal) for use with implantable neurostimulator, replacement only |
| L8690-HCPCS | High | Auditory osseointegrated device, includes all internal and external components |
| L8691-HCPCS | High | Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8690. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8690 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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