L0648 — Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Lso sag r an/pos pnl pre ots” · PA required
- 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
- Required (Medicare, since 2022-10-10)
- Status
- Active (April 2026 HCPCS)
Prior authorization
PA REQUIRED L0648 is on Medicare's DMEPOS Required Prior Authorization List (Orthoses — nationwide since 2022-10-10).
Claims for this item without an affirmed prior-authorization decision are automatically denied (commonly surfacing as CO-197). Submit the PA request to your DME MAC with the order and supporting clinical documentation before delivery.
L0648 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $351.28 to $1235.10 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $1173.55 | — |
| AL | $797.49 | $1032.97 |
| AR | $797.49 | $1032.93 |
| AZ | $752.04 | $1014.43 |
| CA | $351.28 | $1014.43 |
| CO | $523.50 | $1037.74 |
| CT | $797.49 | $1014.43 |
| DC | $699.71 | $1014.43 |
| DE | $699.71 | $1014.43 |
| FL | $797.49 | $1032.97 |
| GA | $797.49 | $1032.97 |
| HI | $1173.55 | — |
| IA | $781.86 | $1026.46 |
| ID | $523.50 | $1014.43 |
| IL | $676.99 | $1029.54 |
| IN | $676.99 | $1029.54 |
| KS | $781.86 | $1026.46 |
| KY | $797.49 | $1032.97 |
| LA | $797.49 | $1032.93 |
| MA | $797.49 | $1014.43 |
| MD | $699.71 | $1014.43 |
| ME | $797.49 | $1014.43 |
| MI | $676.99 | $1029.54 |
| MN | $781.86 | $1029.54 |
| MO | $781.86 | $1026.46 |
| MS | $797.49 | $1032.97 |
| MT | $523.50 | $1037.74 |
| NC | $797.49 | $1032.97 |
| ND | $781.86 | $1037.74 |
| NE | $781.86 | $1026.46 |
| NH | $797.49 | $1014.43 |
| NJ | $699.71 | $1014.43 |
| NM | $752.04 | $1032.93 |
| NV | $351.28 | $1014.43 |
| NY | $699.71 | $1014.43 |
| OH | $676.99 | $1029.54 |
| OK | $752.04 | $1032.93 |
| OR | $351.28 | $1014.43 |
| PA | $699.71 | $1014.43 |
| PR | $1235.10 | — |
| RI | $797.49 | $1014.43 |
| SC | $797.49 | $1032.97 |
| SD | $781.86 | $1037.74 |
| TN | $797.49 | $1032.97 |
| TX | $752.04 | $1032.93 |
| UT | $523.50 | $1037.74 |
| VA | $797.49 | $1014.43 |
| VI | $1235.10 | — |
| VT | $797.49 | $1014.43 |
| WA | $351.28 | $1014.43 |
| WI | $676.99 | $1029.54 |
| WV | $797.49 | $1014.43 |
| WY | $523.50 | $1037.74 |
Common denial codes to watch
Related L-codes
Bill L0648 with confidence
MyMedi-AI scrubs whole claims against NCCI pairs, MUE limits, modifier rules, and PA flags before you submit — built for DME teams, no PHI stored on our servers.
Start free trial Run a CMS-0057-F readiness checkPrefer DIY compliance? Self-audit documentation kits for DME suppliers →