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L1240 — Addition to tlso, (low profile), lumbar derotation pad

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

L1240 Medicare fee schedule (April 2026)

Base (no modifier) Prosthetics & orthotics

Medicare allowable ranges from $83.25 to $148.00 depending on state and rural status.

Former-CBA payment limits: ceiling $118.97 · floor $89.22

StateNon-ruralRural
AK$138.44
AL$112.41
AR$96.35
AZ$118.97
CA$118.97
CO$89.22
CT$96.99
DC$99.53
DE$99.53
FL$112.41
GA$112.41
HI$148.00
IA$89.22
ID$95.36
IL$111.77
IN$111.77
KS$89.22
KY$112.41
LA$96.35
MA$96.99
MD$99.53
ME$96.99
MI$111.77
MN$111.77
MO$89.22
MS$112.41
MT$89.22
NC$112.41
ND$89.22
NE$89.22
NH$96.99
NJ$90.05
NM$96.35
NV$118.97
NY$90.05
OH$111.77
OK$96.35
OR$95.36
PA$99.53
PR$83.25
RI$96.99
SC$112.41
SD$89.22
TN$112.41
TX$96.35
UT$89.22
VA$99.53
VI$90.05
VT$96.99
WA$95.36
WI$111.77
WV$99.53
WY$89.22
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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