MyMedi-AI

L1110 — Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model

HCPCS Level II L-code · short descriptor: “Ring flange plas/leather mol”

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
Face-to-face & WOPD
Not on the required list
MUE unit limit
2
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

L1110 Medicare fee schedule (October 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $184.07 to $523.88 depending on state and rural status.

Former-CBA payment limits: ceiling $391.31 · floor $293.49

StateNon-ruralRural
AK$489.91—
AL$314.94—
AR$296.08—
AZ$391.31—
CA$391.31—
CO$293.49—
CT$346.35—
DC$293.49—
DE$293.49—
FL$314.94—
GA$314.94—
HI$523.88—
IA$369.77—
ID$343.46—
IL$391.31—
IN$391.31—
KS$369.77—
KY$314.94—
LA$296.08—
MA$346.35—
MD$293.49—
ME$346.35—
MI$391.31—
MN$391.31—
MO$369.77—
MS$314.94—
MT$293.49—
NC$314.94—
ND$293.49—
NE$369.77—
NH$346.35—
NJ$293.49—
NM$296.08—
NV$391.31—
NY$293.49—
OH$391.31—
OK$296.08—
OR$343.46—
PA$293.49—
PR$184.07—
RI$346.35—
SC$314.94—
SD$293.49—
TN$314.94—
TX$296.08—
UT$293.49—
VA$293.49—
VI$293.49—
VT$346.35—
WA$343.46—
WI$391.31—
WV$293.49—
WY$293.49—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). 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.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps L1110 at 2 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: Code Descriptor / CPT Instruction.

Common denial codes to watch

Related L-codes

Bill L1110 with confidence

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