L0649 — Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Lso sc r pos/lat pnl 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.
L0649 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $98.12 to $344.99 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $327.82 | — |
| AL | $222.77 | $288.55 |
| AR | $222.77 | $288.53 |
| AZ | $210.07 | $283.37 |
| CA | $98.12 | $283.37 |
| CO | $146.23 | $289.88 |
| CT | $222.77 | $283.37 |
| DC | $195.46 | $283.37 |
| DE | $195.46 | $283.37 |
| FL | $222.77 | $288.55 |
| GA | $222.77 | $288.55 |
| HI | $327.82 | — |
| IA | $218.40 | $286.71 |
| ID | $146.23 | $283.37 |
| IL | $189.11 | $287.59 |
| IN | $189.11 | $287.59 |
| KS | $218.40 | $286.71 |
| KY | $222.77 | $288.55 |
| LA | $222.77 | $288.53 |
| MA | $222.77 | $283.37 |
| MD | $195.46 | $283.37 |
| ME | $222.77 | $283.37 |
| MI | $189.11 | $287.59 |
| MN | $218.40 | $287.59 |
| MO | $218.40 | $286.71 |
| MS | $222.77 | $288.55 |
| MT | $146.23 | $289.88 |
| NC | $222.77 | $288.55 |
| ND | $218.40 | $289.88 |
| NE | $218.40 | $286.71 |
| NH | $222.77 | $283.37 |
| NJ | $195.46 | $283.37 |
| NM | $210.07 | $288.53 |
| NV | $98.12 | $283.37 |
| NY | $195.46 | $283.37 |
| OH | $189.11 | $287.59 |
| OK | $210.07 | $288.53 |
| OR | $98.12 | $283.37 |
| PA | $195.46 | $283.37 |
| PR | $344.99 | — |
| RI | $222.77 | $283.37 |
| SC | $222.77 | $288.55 |
| SD | $218.40 | $289.88 |
| TN | $222.77 | $288.55 |
| TX | $210.07 | $288.53 |
| UT | $146.23 | $289.88 |
| VA | $222.77 | $283.37 |
| VI | $344.99 | — |
| VT | $222.77 | $283.37 |
| WA | $98.12 | $283.37 |
| WI | $189.11 | $287.59 |
| WV | $222.77 | $283.37 |
| WY | $146.23 | $289.88 |
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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