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L1090 — Addition to ctlso or scoliosis orthosis, lumbar sling

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

L1090 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $71.58 to $167.79 depending on state and rural status.

Former-CBA payment limits: ceiling $140.44 · floor $105.33

StateNon-ruralRural
AK$156.93
AL$105.33
AR$117.80
AZ$140.44
CA$140.44
CO$113.77
CT$105.33
DC$135.96
DE$135.96
FL$105.33
GA$105.33
HI$167.79
IA$106.37
ID$114.21
IL$123.66
IN$123.66
KS$106.37
KY$105.33
LA$117.80
MA$105.33
MD$135.96
ME$105.33
MI$123.66
MN$123.66
MO$106.37
MS$105.33
MT$113.77
NC$105.33
ND$113.77
NE$106.37
NH$105.33
NJ$115.60
NM$117.80
NV$140.44
NY$115.60
OH$123.66
OK$117.80
OR$114.21
PA$135.96
PR$71.58
RI$105.33
SC$105.33
SD$113.77
TN$105.33
TX$117.80
UT$113.77
VA$135.96
VI$115.60
VT$105.33
WA$114.21
WI$123.66
WV$135.96
WY$113.77
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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