L0651 — Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf
HCPCS Level II L-code · short descriptor: “Lso sag-co shell 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 2026-04-13)
- Status
- Active (April 2026 HCPCS)
Prior authorization
PA REQUIRED L0651 is on Medicare's DMEPOS Required Prior Authorization List (Orthoses — nationwide since 2026-04-13).
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.
L0651 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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