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L1050 — Addition to ctlso or scoliosis orthosis, sternal pad

HCPCS Level II L-code · short descriptor: “Sternal pad”

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.

L1050 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $51.17 to $141.90 depending on state and rural status.

Former-CBA payment limits: ceiling $127.57 · floor $95.68

StateNon-ruralRural
AK$132.71
AL$101.56
AR$123.34
AZ$127.57
CA$127.57
CO$95.68
CT$95.68
DC$115.32
DE$115.32
FL$101.56
GA$101.56
HI$141.90
IA$95.68
ID$117.78
IL$123.31
IN$123.31
KS$95.68
KY$101.56
LA$123.34
MA$95.68
MD$115.32
ME$95.68
MI$123.31
MN$123.31
MO$95.68
MS$101.56
MT$95.68
NC$101.56
ND$95.68
NE$95.68
NH$95.68
NJ$95.68
NM$123.34
NV$127.57
NY$95.68
OH$123.31
OK$123.34
OR$117.78
PA$115.32
PR$51.17
RI$95.68
SC$101.56
SD$95.68
TN$101.56
TX$123.34
UT$95.68
VA$115.32
VI$95.68
VT$95.68
WA$117.78
WI$123.31
WV$115.32
WY$95.68
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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