L0650 — Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on 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 sc r ant/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 L0650 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.
L0650 Medicare fee schedule (April 2026)
Base (no modifier) Prosthetics & orthotics
Medicare allowable ranges from $406.45 to $1440.51 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $1388.99 | — |
| AL | $922.75 | $1302.42 |
| AR | $922.75 | $1211.87 |
| AZ | $870.15 | $1186.97 |
| CA | $406.45 | $1186.97 |
| CO | $605.72 | $1105.67 |
| CT | $922.75 | $1163.63 |
| DC | $809.61 | $1105.67 |
| DE | $809.61 | $1105.67 |
| FL | $922.75 | $1302.42 |
| GA | $922.75 | $1302.42 |
| HI | $1440.51 | — |
| IA | $904.66 | $1189.64 |
| ID | $605.72 | $1135.46 |
| IL | $783.31 | $1257.43 |
| IN | $783.31 | $1257.43 |
| KS | $904.66 | $1189.64 |
| KY | $922.75 | $1302.42 |
| LA | $922.75 | $1211.87 |
| MA | $922.75 | $1163.63 |
| MD | $809.61 | $1105.67 |
| ME | $922.75 | $1163.63 |
| MI | $783.31 | $1257.43 |
| MN | $904.66 | $1257.43 |
| MO | $904.66 | $1189.64 |
| MS | $922.75 | $1302.42 |
| MT | $605.72 | $1105.67 |
| NC | $922.75 | $1302.42 |
| ND | $904.66 | $1105.67 |
| NE | $904.66 | $1189.64 |
| NH | $922.75 | $1163.63 |
| NJ | $809.61 | $1105.67 |
| NM | $870.15 | $1211.87 |
| NV | $406.45 | $1186.97 |
| NY | $809.61 | $1105.67 |
| OH | $783.31 | $1257.43 |
| OK | $870.15 | $1211.87 |
| OR | $406.45 | $1135.46 |
| PA | $809.61 | $1105.67 |
| PR | $1359.30 | — |
| RI | $922.75 | $1163.63 |
| SC | $922.75 | $1302.42 |
| SD | $904.66 | $1105.67 |
| TN | $922.75 | $1302.42 |
| TX | $870.15 | $1211.87 |
| UT | $605.72 | $1105.67 |
| VA | $922.75 | $1105.67 |
| VI | $1288.60 | — |
| VT | $922.75 | $1163.63 |
| WA | $406.45 | $1135.46 |
| WI | $783.31 | $1257.43 |
| WV | $922.75 | $1105.67 |
| WY | $605.72 | $1105.67 |
Common denial codes to watch
Related L-codes
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