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See a sample rate comparisonHealthcare 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 Miscellaneous Orthotic and Prosthetic Services and Supplies |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for L8696 |
National average reimbursement for HCPCS L8696 by major payers:

$217.39

$146.12

$155.96

$311.91
Choose a payer to see a sample of rates for HCPCS L8696.
Merrimack Valley Pediatric Associates, Inc.
Gwinnett Obgyn Associates Of Georgia LLC
Redmond Park Hospital LLC
Miguel A Arenas Md PC
Miguel A Arenas Md PC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS L8696 vs. Other Miscellaneous Orthotic and Prosthetic Services and Supplies Codes
The HCPCS L8696 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 L8696 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 |
|---|---|---|
| L8695-HCPCS | Low | External recharging system for battery (external) for use with implantable neurostimulator, replacement only |
| L8696-HCPCS | Moderate | Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each |
| L8698-HCPCS | Low | Miscellaneous component, supply or accessory for use with total artificial heart system |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8696. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8696 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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