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L1010 — Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling

HCPCS Level II L-code · short descriptor: “Ctlso axilla sling”

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.

L1010 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $51.03 to $102.83 depending on state and rural status.

Former-CBA payment limits: ceiling $102.83 · floor $77.12

StateNon-ruralRural
AK$84.32
AL$93.95
AR$90.90
AZ$87.29
CA$87.29
CO$77.12
CT$85.13
DC$77.12
DE$77.12
FL$93.95
GA$93.95
HI$90.13
IA$86.08
ID$79.98
IL$102.83
IN$102.83
KS$86.08
KY$93.95
LA$90.90
MA$85.13
MD$77.12
ME$85.13
MI$102.83
MN$102.83
MO$86.08
MS$93.95
MT$77.12
NC$93.95
ND$77.12
NE$86.08
NH$85.13
NJ$77.12
NM$90.90
NV$87.29
NY$77.12
OH$102.83
OK$90.90
OR$79.98
PA$77.12
PR$51.03
RI$85.13
SC$93.95
SD$77.12
TN$93.95
TX$90.90
UT$77.12
VA$77.12
VI$77.12
VT$85.13
WA$79.98
WI$102.83
WV$77.12
WY$77.12
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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