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L1060 — Addition to ctlso or scoliosis orthosis, thoracic pad

HCPCS Level II L-code · short descriptor: “Thoracic 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.

L1060 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $81.66 to $170.96 depending on state and rural status.

Former-CBA payment limits: ceiling $146.53 · floor $109.90

StateNon-ruralRural
AK$159.83
AL$114.57
AR$119.70
AZ$146.53
CA$146.53
CO$109.90
CT$114.27
DC$138.32
DE$138.32
FL$114.57
GA$114.57
HI$170.96
IA$113.05
ID$129.48
IL$133.10
IN$133.10
KS$113.05
KY$114.57
LA$119.70
MA$114.27
MD$138.32
ME$114.27
MI$133.10
MN$133.10
MO$113.05
MS$114.57
MT$109.90
NC$114.57
ND$109.90
NE$113.05
NH$114.27
NJ$109.90
NM$119.70
NV$146.53
NY$109.90
OH$133.10
OK$119.70
OR$129.48
PA$138.32
PR$81.66
RI$114.27
SC$114.57
SD$109.90
TN$114.57
TX$119.70
UT$109.90
VA$138.32
VI$109.90
VT$114.27
WA$129.48
WI$133.10
WV$138.32
WY$109.90
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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