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HCPCS L5657

Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials

Reported by 25 hospitals in the network under the fee schedule methodology.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

Reflects negotiated fee schedule rates with commercial payers.

National pricing summary

Low

$119

Average

$300

Median

$309

High

$549

Hospitals reporting this code

#HospitalLocation
1Medical City MckinneyMcKinney, TX$97$125$119$137$16
2Medical City North HillsNorth Richland Hills, TX$97$125$119$137$16
3Hca Florida North Florida HospitalNEWBERRY, FL$276$312$316$368$21
4Texas Orthopedic HospitalHOUSTON, TX$115$316$332$671$104
5Hca Houston Healthcare KingwoodHUMBLE, TX$115$316$335$659$104
6Hca Houston Healthcare ConroeCONROE, TX$115$316$331$659$101
7HCA Houston Healthcare North CypressHOUSTON, TX$115$316$308$659$82
8The Womans Hospital Of TexasHOUSTON, TX$115$316$332$671$103
9Hca Houston Healthcare WestHOUSTON, TX$115$316$330$659$99
10Methodist Hospital AtascosaJourdanton, TX$82$306$285$429$75
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