L0450 — Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf

HCPCS Level II L-code · short descriptor: “Tlso flex trunk/thor 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.

L0450 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $63.92 to $252.57 depending on state and rural status.

State	Non-rural	Rural
AK	$242.76	—
AL	$145.10	$188.72
AR	$145.10	$172.41
AZ	$136.83	$205.69
CA	$63.92	$205.69
CO	$95.25	$172.41
CT	$145.10	$205.69
DC	$127.31	$174.29
DE	$127.31	$174.29
FL	$145.10	$188.72
GA	$145.10	$188.72
HI	$252.57	—
IA	$142.26	$184.97
ID	$95.25	$204.43
IL	$123.17	$172.41
IN	$123.17	$172.41
KS	$142.26	$184.97
KY	$145.10	$188.72
LA	$145.10	$172.41
MA	$145.10	$205.69
MD	$127.31	$174.29
ME	$145.10	$205.69
MI	$123.17	$172.41
MN	$142.26	$172.41
MO	$142.26	$184.97
MS	$145.10	$188.72
MT	$95.25	$172.41
NC	$145.10	$188.72
ND	$142.26	$172.41
NE	$142.26	$184.97
NH	$145.10	$205.69
NJ	$127.31	$189.51
NM	$136.83	$172.41
NV	$63.92	$205.69
NY	$127.31	$189.51
OH	$123.17	$172.41
OK	$136.83	$172.41
OR	$63.92	$204.43
PA	$127.31	$174.29
PR	$231.44	—
RI	$145.10	$205.69
SC	$145.10	$188.72
SD	$142.26	$172.41
TN	$145.10	$188.72
TX	$136.83	$172.41
UT	$95.25	$172.41
VA	$145.10	$174.29
VI	$218.46	—
VT	$145.10	$205.69
WA	$63.92	$204.43
WI	$123.17	$172.41
WV	$145.10	$174.29
WY	$95.25	$172.41

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

CO-50 medical necessity

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