Payment Rates for Repair Time
When a DMEPOS item is in need of repair, there are specific HCPCS codes to use in billing the time and parts.
When a brace or prosthesis needs repairs and is no longer under manufacturer's warranty, a supplier may repair the device and submit a claim to the DME MAC. Use appropriate HCPCS for the materials in the repair and a separate HCPCS for the labor time of the repair.
Cost of parts:
L4210 REPAIR OF ORTHOTIC DEVICE, REPAIR OR REPLACE MINOR PARTS
L7510 REPAIR OF PROSTHETIC DEVICE, REPAIR OR REPLACE MINOR PARTS
Cost of labor*:
L4205 REPAIR OF ORTHOTIC DEVICE, LABOR COMPONENT, PER 15 MINUTES
L7520 REPAIR PROSTHETIC DEVICE, LABOR COMPONENT, PER 15 MINUTES
*Bill these codes in 15-minute increments for actual time involved in repairs. (If the repair is required within the applicable warranty period for the device, it is included in the initial cost of the device.) If the labor time involved in the repair is 30 minutes, you will bill 2 units of the code.
Modifier RB
The claim will include the HCPCS code of the base product along with the modifier RB, which indicates this item is being repaired.
The allowable amounts for the labor codes can be found here.
Download the Repair of Orthotic and Prosthetic Items guide sheet under Reimbursement Resources.