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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.

StateNon-ruralRural
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
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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