L0174 — Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Cerv sr 2pc thor ext pre ots”
- Code system
- HCPCS Level II
- Family
- L — Orthotics & prosthetics
- Medicare coverage status
- Carrier judgment — coverage decided by the DME MAC
- DMEPOS payment category
- Prosthetics & orthotics
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
L0174 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $247.47 to $537.31 depending on state and rural status.
Former-CBA payment limits: ceiling $420.89 · floor $315.67
| State | Non-rural | Rural |
|---|---|---|
| AK | $502.47 | — |
| AL | $315.67 | — |
| AR | $315.67 | — |
| AZ | $420.89 | — |
| CA | $420.89 | — |
| CO | $369.22 | — |
| CT | $420.89 | — |
| DC | $315.67 | — |
| DE | $315.67 | — |
| FL | $315.67 | — |
| GA | $315.67 | — |
| HI | $537.31 | — |
| IA | $334.12 | — |
| ID | $331.73 | — |
| IL | $342.24 | — |
| IN | $342.24 | — |
| KS | $334.12 | — |
| KY | $315.67 | — |
| LA | $315.67 | — |
| MA | $420.89 | — |
| MD | $315.67 | — |
| ME | $420.89 | — |
| MI | $342.24 | — |
| MN | $342.24 | — |
| MO | $334.12 | — |
| MS | $315.67 | — |
| MT | $369.22 | — |
| NC | $315.67 | — |
| ND | $369.22 | — |
| NE | $334.12 | — |
| NH | $420.89 | — |
| NJ | $315.67 | — |
| NM | $315.67 | — |
| NV | $420.89 | — |
| NY | $315.67 | — |
| OH | $342.24 | — |
| OK | $315.67 | — |
| OR | $331.73 | — |
| PA | $315.67 | — |
| PR | $247.47 | — |
| RI | $420.89 | — |
| SC | $315.67 | — |
| SD | $369.22 | — |
| TN | $315.67 | — |
| TX | $315.67 | — |
| UT | $369.22 | — |
| VA | $315.67 | — |
| VI | $315.67 | — |
| VT | $420.89 | — |
| WA | $331.73 | — |
| WI | $342.24 | — |
| WV | $315.67 | — |
| WY | $369.22 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related L-codes
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