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See a sample rate comparisonHCPCS L8698 Fee Schedule
Last Verified: October 2026
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.
Miscellaneous component, supply or accessory for use with total artificial heart system
| Key Fact | Detail |
|---|---|
| Service Type | Prosthetic Procedures Miscellaneous Orthotic and Prosthetic Services and Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS L8698 by major payers:
$48.75
$1,272.00
$49.42
$49,999.50
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HCPCS L8698
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See a sample payer proposalHCPCS L8698 vs. Other Miscellaneous Orthotic and Prosthetic Services and Supplies Codes
The HCPCS L8698 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 L8698 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 |
|---|---|---|
| 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 |
| L8699-HCPCS | Moderate | Prosthetic implant, not otherwise specified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L8698. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L8698 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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